• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Laparoscopic procedures in patients with cardiac ventricular assist devices
【24h】

Laparoscopic procedures in patients with cardiac ventricular assist devices

机译：心室辅助装置患者的腹腔镜手术

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BackgroundCardiac left ventricular assist device (LVAD) placement is a common therapy for heart failure. Non-cardiac surgical care of these patients can be complex given the need for anticoagulation, perioperative monitoring, comorbidities, and anatomical considerations due to the device itself. There are no guidelines or significant patient series reported to date for laparoscopic procedures in this population. We herein report the techniques and outcomes for commonly performed laparoscopic procedures in patients with LVADs at a high volume center.MethodsFrom our database of patients with ventricular assist devices, we retrospectively identified patients who underwent laparoscopic abdominal surgery. Intraoperative and perioperative data were collected, including anticoagulation management, transfusions and complications. Techniques and preoperative considerations from the surgeons were also compiled and described.ResultsOf 374 patients that had placement of LVADs, 17 had an elective laparoscopic procedure: enteral access placement (n=7), cholecystectomy (n=6), hernia repair (n=2), small bowel resection (n=1) and splenectomy (n=1). Preoperative evaluation routinely included radiologic imaging to evaluate driveline location. The most common abdominal entry technique was a periumbilical open Hasson technique (11/17). No cases were converted to open. Overall, the average blood loss was 13264mL and the average operative time was 1.8 +/- 0.3h. Five of the 17 patients required intraoperative blood transfusion. No patients suffered perioperative thrombotic events or LVAD complications secondary to holding anticoagulation. No patients required interventions or reoperation for bleeding complications. There were no mortalities related to these procedures.Conclusions Laparoscopic abdominal procedures are safe and feasible in patients with LVADs. Although special consideration for bleeding and thrombotic risks, placement of ports and perioperative management is required, the presence of a LVAD itself should not be considered a contraindication for laparoscopic surgery and may in fact be the preferred method for access in these patients.
机译：背景卡片左心室辅助装置（LVAD）放置是心力衰竭的常见疗法。鉴于设备本身，这些患者的非心脏手术护理可以复杂，鉴于抗凝，围手术期监测，组合和解剖考虑因素。在本人腹腔镜程序日期没有报告的指导方针或重要的患者系列。我们在此报告了在高批量中心的LVAD患者中常见的腹腔镜手术的技术和结果。从患有心室辅助装置的患者数据库，我们回顾性地鉴定了接受腹腔镜腹部手术的患者。收集术中和围手术期数据，包括抗凝血管理，输血和并发症。从外科医生的技术和术前考虑也被编制和描述。374患者的患者提供了LVAD，17的患者有一个选修腹腔镜程序：肠内进入放置（n = 7），胆囊切除术（n = 6），疝修复（n = 2），小肠切除（n = 1）和脾切除术（n = 1）。术前评估常规包括放射学成像来评估传动系统的位置。最常见的腹部进入技术是一部Proiumbilical开放的哈希酮技术（11/17）。没有案件转换为开放。总体而言，平均失血为13264毫升，平均手术时间为1.8 +/- 0.3h。 17例患者中的五种需要术中输血。没有患者患有围手术期血栓形成事件或继发于抗凝凝血的LVAD并发症。没有患者需要干预或再次出血并发症。没有与这些程序有关的死亡率。腹腔镜腹部手术在LVAD患者中是安全可行的。虽然需要出血和血栓形成风险的特殊考虑，但需要放置港口和围手术期管理，但不应被视为腹腔镜手术的禁忌症，实际上可能是这些患者的优选方法。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号