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Brazilian Society of Angiology and Vascular Surgery guidelines on peripheral artery disease. 巴西血管病学和血管外科学会外周动脉疾病指南。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-10-28 eCollection Date: 2024-01-01 DOI: 10.1590/1677-5449.202300592
Fabiano Luiz Erzinger, Afonso César Polimanti, Daniel Mendes Pinto, Gustavo Murta, Marcus Vinicius Cury, Ricardo Bernardo da Silva, Rodrigo Bruno Biagioni, Sergio Quilici Belckzac, Edwaldo Edner Joviliano, Walter Junior Boin de Araujo, Julio Cesar Peclat de Oliveira

Patients with peripheral artery disease and generalized atherosclerosis are at high risk of cardiovascular and limb complications, affecting both quality of life and longevity. Lower limb atherosclerotic disease is associated with high cardiovascular morbidity and mortality and adequate management is founded on treatments involving patient-dependent factors, such as lifestyle changes, and physician-dependent factors, such as clinical treatment, endovascular treatment, or conventional surgery. Medical management of peripheral artery disease is multifaceted, and its most important elements are reduction of cholesterol level, antithrombotic therapy, control of arterial blood pressure, control of diabetes, and smoking cessation. Adhesion to this regime can reduce complications related to the limbs, such as chronic limb-threatening ischemia, that can result in amputation, and the systemic complications of atherosclerosis, such as stroke and myocardial infarction.

患有外周动脉疾病和全身动脉粥样硬化的患者极易出现心血管和肢体并发症,影响生活质量和寿命。下肢动脉粥样硬化性疾病与心血管疾病的高发病率和高死亡率相关,而适当的治疗则建立在患者因素(如改变生活方式)和医生因素(如临床治疗、血管内治疗或传统手术)的基础上。外周动脉疾病的医学治疗是多方面的,其中最重要的因素是降低胆固醇水平、抗血栓治疗、控制动脉血压、控制糖尿病和戒烟。坚持这种治疗方法可以减少与肢体有关的并发症,如可能导致截肢的慢性肢体缺血,以及动脉粥样硬化的全身并发症,如中风和心肌梗死。
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引用次数: 0
Cross-sectional, multicenter study comparing sex differences in patients undergoing endovascular repair of infrarenal abdominal aortic aneurysms. Results from the São Paulo State University Provincial Hospitals Registry (RHEUNI). 横断面多中心研究:比较肾下腹主动脉瘤血管内修复术患者的性别差异。来自圣保罗州立大学省级医院登记处(RHEUNI)的结果。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-10-28 eCollection Date: 2024-01-01 DOI: 10.1590/1677-5449.202400042
Regina Moura, Edwaldo Edner Joviliano, Ana Terezinha Guillaumon, Selma Regina de Oliveira Raymundo, Ludwig Hafner, Marcone Lima Sobreira, Marcelo José de Almeida, Daniel Gustavo Miquelin, Martin Geiger, Winston Bonetti Yoshida

Background: Abdominal aortic aneurysms (AAA) are 4-6 times more frequent among men than among women, but prognosis tends to be worse in women.

Objective: To compare endovascular procedures to repair infrarenal AAA in men and women, using data from a prospective registry.

Methods: This registry collected data from five university hospitals in the state of São Paulo (Brazil) from 2012 to 2022. A cross-sectional study was conducted compiling demographic data, anatomic variables (aneurysm diameter, short neck, angulated neck, calcified neck, or thrombosed neck; distal neck < 1.5 cm, and tortuous, abnormal iliac arteries), complications (leaks, conversions, and patency or stenosis of branches) and renal failure and mortality at 30 days. The chi-square test and Student's t test were applied with a 5% significance level. The study was approved by the Ethics Committee (process 4040-2011).

Results: A total of 152 (15.9%) of the patients were women and 799 (84.0%) were men (p < 0.05). The majority were white (80.2% of the women and 87.4% of the men). Diabetes and hypertension were significantly more frequent among the women. The most prevalent shape was fusiform, particularly among the women (95.39% vs. 89.86% among men). Mean diameter was smaller among the women (5.96 cm vs. 6.49 cm; p = 0.0056). The iliac arteries were less often involved among the women (89.40% vs. 73.58%; p = 0.00001). Blood loss was greater in the men (321.40 ml vs. 168.84 ml among the women; p < 0.05). Operative mortality was similar in both sexes, but obstructions were more frequent among the women (15.2% vs. 13.51%; p = 0.017296).

Conclusions: Aneurysmal diameter was smaller and obstructive complications were more frequent among women.

背景:腹主动脉瘤(AAA)在男性中的发病率是女性的4-6倍,但女性的预后往往较差:利用前瞻性登记数据,比较男性和女性修复肾下主动脉瘤的血管内手术:该登记处收集了 2012 年至 2022 年巴西圣保罗州五所大学医院的数据。这项横断面研究收集了人口统计学数据、解剖变量(动脉瘤直径、短颈、成角颈、钙化颈或血栓形成颈;远端颈< 1.5厘米,以及迂曲、异常的髂动脉)、并发症(渗漏、转化、分支通畅或狭窄)以及肾衰竭和30天后的死亡率。采用卡方检验和学生 t 检验,显著性水平为 5%。该研究获得了伦理委员会的批准(流程 4040-2011):共有 152 名(15.9%)女性患者和 799 名(84.0%)男性患者(P < 0.05)。大多数患者为白人(女性占 80.2%,男性占 87.4%)。女性患糖尿病和高血压的比例明显更高。最常见的形状是纺锤形,尤其是在女性中(95.39%,男性为 89.86%)。女性的平均直径较小(5.96 厘米对 6.49 厘米;P = 0.0056)。女性髂动脉受累较少(89.40% 对 73.58%;P = 0.00001)。男性的失血量更大(321.40 毫升对女性的 168.84 毫升;P < 0.05)。男女患者的手术死亡率相似,但女性患者的梗阻发生率更高(15.2% 对 13.51%;P = 0.017296):结论:女性动脉瘤直径更小,阻塞并发症更常见。
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引用次数: 0
Analysis of the efficacy of endovascular treatment with foam sclerotherapy for pelvic congestion syndrome with ultrasound assessment. 通过超声评估分析血管内泡沫硬化疗法治疗盆腔充血综合征的疗效。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-10-21 eCollection Date: 2024-01-01 DOI: 10.1590/1677-5449.202301782
Natália Miranda Gava, Amanda Santana Silva, Gustavo Sasso Benso Maciel, Márcia Porto Assis, Carlos André Daher Santos

Background: Pelvic Congestion Syndrome is an important cause of pelvic pain in adult women, leading to reduced quality of life, absenteeism from work, anxiety, depression, and sexual disorders.

Objectives: To evaluate the response to endovascular treatment for pelvic varicose veins using foam sclerotherapy and outline the profile of patients with this diagnosis followed up at the Hospital das Clínicas Cassiano Antônio Moraes, Universidade Federal do Espírito Santo, Brazil.

Methods: Based on review of medical records, this retrospective descriptive study analyzes the profile and response of patients undergoing endovascular treatment for pelvic varicose veins by foam sclerotherapy. The variables analyzed include age, weight, height, body mass index, parity, pelvic pain complaints, ultrasound criteria comparing the diameter of pelvic vessels before and after the procedure, and presence of venous reflux on transvaginal Doppler ultrasound.

Results: The sample of patients analyzed had an average age of 43.3 years old, a mean of 2.95 gestations, and a mean BMI of 25.37kg/m2. Ultrasound assessment after the intervention indicated a statistically significant reduction (p-value < 0.005) in the caliber of the parauterine vessels, with mean diameters of 6.34 mm on the right and 7.26 mm on the left before the procedure and 4.37 mm and 4.56 mm respectively afterwards.

Conclusions: Foam sclerotherapy reduced the caliber of pelvic varicose veins in the study sample. The results were similar to those of other endovascular treatment methods for this comorbidity. Further prospective studies to assess the response to this intervention are necessary to establish it as an effective option for treatment of pelvic congestion syndrome.

背景:盆腔充血综合征是成年女性盆腔疼痛的重要原因:盆腔充血综合征是成年女性盆腔疼痛的一个重要原因,会导致生活质量下降、旷工、焦虑、抑郁和性功能障碍:目的:评估巴西圣埃斯皮里图联邦大学卡西亚诺-安东尼奥-莫赖斯医院采用泡沫硬化疗法对盆腔静脉曲张血管内治疗的反应,并概述该诊断患者的概况:这项回顾性描述性研究以病历为基础,分析了通过泡沫硬化剂注射对盆腔静脉曲张进行血管内治疗的患者的概况和反应。分析的变量包括年龄、体重、身高、体重指数、胎次、盆腔疼痛主诉、比较手术前后盆腔血管直径的超声标准以及经阴道多普勒超声检查是否存在静脉回流:所分析的样本患者平均年龄为 43.3 岁,平均妊娠次数为 2.95 次,平均体重指数为 25.37kg/m2。干预后的超声波评估显示,子宫旁血管的直径在统计学上显著缩小(p 值< 0.005),术前右侧和左侧的平均直径分别为 6.34 毫米和 7.26 毫米,术后分别为 4.37 毫米和 4.56 毫米:结论:泡沫硬化疗法可缩小研究样本中盆腔静脉曲张的直径。其结果与其他血管内治疗方法对这一合并症的治疗效果相似。有必要进一步开展前瞻性研究,评估这种干预方法的反应,将其确定为治疗盆腔充血综合征的有效方法。
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引用次数: 0
Treatment of penetrating injuries of the retrohepatic vena cava: systematic review protocol. 肝后腔静脉穿透性损伤的治疗:系统综述方案。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-10-09 eCollection Date: 2024-01-01 DOI: 10.1590/1677-5449.202400032
Adenauer Marinho de Oliveira Góes, Simone de Campos Vieira Abib, Gustavo Henrique Dumont Kleinsorge, Daniella Adrea Araujo Rossi Vieira, Luis Carlos Uta Nakano

Injuries to the retrohepatic segment of the inferior vena cava require complex procedures, as exposure without prior vascular control can lead to uncontrollable and fatal bleeding. To achieve such control, the classic techniques of hepatic vascular exclusion and the implantation of an atriocaval shunt have been described, and more recently, endovascular strategies have been reported. However, there is no consensus in the literature regarding which of these strategies is associated with lower mortality. In order to determine which therapeutic strategy presents the lowest mortality and complication rates in the treatment of penetrating injuries to the retrohepatic segment of the inferior vena cava, a systematic review of the literature will be conducted, registered on the PROSPERO platform under the number CRD42023464133. The Cochrane Handbook for Systematic Reviews of Interventions will guide the process. Searches will be carried out in the MEDLINE/PubMed, LILACS, Embase, Scopus, and Web of Science databases. ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP) will be consulted to detect ongoing or unpublished trials. Studies will be selected based on a predefined search strategy, the number of results will be filtered using the Rayyan app, and the studies included will be independently reviewed by two authors to reach a final consensus. The qualitative analysis of the studies will be conducted using the RoB 1.0 tool.

下腔静脉肝后段的损伤需要复杂的手术,因为在没有事先控制血管的情况下暴露可能会导致无法控制的致命出血。为了实现这种控制,肝血管排除和植入阿氏分流术等经典技术已被描述过,最近又有关于血管内治疗策略的报道。然而,关于哪种治疗策略能降低死亡率,文献中还没有达成共识。为了确定在治疗下腔静脉肝后段穿透性损伤时,哪种治疗策略的死亡率和并发症发生率最低,我们将对文献进行系统综述,并在 PROSPERO 平台上注册,注册号为 CRD42023464133。将以 Cochrane 《干预措施系统综述手册》为指导。将在 MEDLINE/PubMed、LILACS、Embase、Scopus 和 Web of Science 数据库中进行检索。还将查阅 ClinicalTrials.gov 和国际临床试验注册平台 (ICTRP),以发现正在进行或尚未公布的试验。将根据预先确定的搜索策略选择研究,使用 Rayyan 应用程序过滤结果数量,并由两位作者对纳入的研究进行独立审查,以达成最终共识。研究的定性分析将使用 RoB 1.0 工具进行。
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引用次数: 0
Response to 1064 nm Nd:YAG LASER in treatment of vulvar Fordyce's Angiokeratoma: case report. 1064 nm Nd:YAG 激光治疗外阴福特斯氏血管角化瘤的反应:病例报告。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-10-07 eCollection Date: 2024-01-01 DOI: 10.1590/1677-5449.202301212
Cláudia Carvalho Sathler-Melo, Daniel Mendes-Pinto, Guilherme de Castro-Santos

Fordyce's Angiokeratoma (AKF) is a benign type of vascular lesion that affects the male and female external genitalia. Prevalence is unknown and there is no apparent hereditary component. Diagnosis can be suggested by ectoscopy, by the presence of purple, bluish, black or red papules on the vulva, clitoris, scrotum, or penis body or glans. Most patients are asymptomatic. Various methods have been used for treatment, including surgery, electrocoagulation, chemical cauterization, sclerotherapy, and LASER. The effectiveness and complications of these therapies are varied. The purpose of this article is to report the case of a 56-year-old woman with abundant and painful vulvar lesions treated with a 1064 nm Nd:YAG LASER. The 1064 nm Nd:YAG LASER proved to be a viable therapeutic option, with satisfactory results and a low rate of complications.

福特斯血管角化瘤(AKF)是一种影响男性和女性外生殖器的良性血管病变。发病率尚不清楚,也没有明显的遗传因素。外阴、阴蒂、阴囊、阴茎体或龟头出现紫色、淡蓝色、黑色或红色丘疹时,可通过外阴镜检查进行诊断。大多数患者没有症状。治疗方法多种多样,包括手术、电凝、化学烧灼、硬化疗法和激光。这些疗法的效果和并发症各不相同。本文旨在报告一例用 1064 nm Nd:YAG 激光治疗外阴大量病变并伴有疼痛的 56 岁妇女的病例。事实证明,1064 nm Nd:YAG 激光是一种可行的治疗方法,效果令人满意,并发症发生率较低。
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引用次数: 0
Ultrasound-guided mini-incision technique for CHIVA. 超声引导下的 CHIVA 小切口技术。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-10-07 eCollection Date: 2024-01-01 DOI: 10.1590/1677-5449.202201572
Felipe Puricelli Faccini, Marcelo Halfen Grill

CHIVA (Cure Conservatrice et Hemodynamique de l'Insuffisance Veineuse en Ambulatoire) is a surgical technique for varicose veins that avoids destroying the saphenous vein and collaterals. In some patients, the flush ligation of saphenous collaterals performed in the CHIVA technique may require more dissection than is desirable. This is especially valid for obese patients and thigh ligations. We report an innovative technique that uses duplex-guided puncture to bring the collateral closer to the skin and reduce the need for dissection and incision. The technique does not change any of the CHIVA principles. While the long-term results are not yet known, we expect them to be similar to normal CHIVA procedures.

CHIVA(Cure Conservatrice et Hemodynamique de l'Insuffisance Veineuse en Ambulatoire)是一种治疗静脉曲张的手术技术,可避免破坏大隐静脉和瓣膜。对于某些患者来说,CHIVA 技术中的隐静脉瓣膜齐平结扎术可能需要进行更多的剥离。这一点尤其适用于肥胖患者和大腿结扎手术。我们报告了一种创新技术,该技术使用双相引导穿刺,使副肢更靠近皮肤,减少剥离和切口的需要。该技术没有改变 CHIVA 的任何原则。虽然长期效果尚未可知,但我们预计其效果将与正常的 CHIVA 手术相似。
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引用次数: 0
Urgent endovascular treatment of juxtarenal aneurysm using a parallel grafts technique. 使用并行移植物技术对并隔动脉瘤进行紧急血管内治疗。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-10-04 eCollection Date: 2024-01-01 DOI: 10.1590/1677-5449.202000282
Fábio Augusto Cypreste Oliveira, Bruno Campos Coelho, Marina Balestra, Juliana Caetano Barreto Cypreste Oliveira, Maria Cunha Ribeiro Amorelli, Davi Douglas Heckmann, Carlos Eduardo de Sousa Amorelli, Fábio Lemos Campedelli

Abdominal aortic aneurysms can constitute a therapeutic challenge in several anatomical scenarios, making endovascular treatment more complex. A juxtarenal abdominal aortic aneurysm (JR-AAA) is defined by the absence of a proximal landing zone in the infrarenal segment and, therefore, techniques must be used to obtain an adequate neck for fixing the endoprostheses without provoking occlusion of renal arteries and visceral branches. The parallel grafts technique, physician-modified stent-graft, industry customized endoprostheses, and off-the-shelf branched endoprosthesis are techniques used in abdominal aneurysms with inadequate proximal neck, but each technique has its indications, limitations, and risks. In this therapeutic challenge, we present a case of urgent endovascular treatment of a JR-AAA using a parallel grafts technique, with good medium-term results, and discuss the therapeutic options.

腹主动脉瘤在多种解剖情况下都会对治疗构成挑战,从而使血管内治疗变得更加复杂。肾下段腹主动脉瘤(JR-AAA)的定义是没有近端着床区,因此必须使用各种技术来获得足够的颈部以固定内支架,同时不引起肾动脉和内脏分支的闭塞。平行移植物技术、医生改良支架移植物、工业定制的内膜假体和现成的分支内膜假体是用于近端颈部不足的腹部动脉瘤的技术,但每种技术都有其适应症、局限性和风险。在这一治疗难题中,我们介绍了一例使用平行移植物技术对 JR-AAA 进行紧急血管内治疗的病例,取得了良好的中期效果,并讨论了治疗方案。
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引用次数: 0
Regarding the article "Entrustable Professional Activities (EPAs) for the residency program in vascular surgery". 关于 "血管外科住院医师培训项目的可委托专业活动 (EPA) "一文。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-27 eCollection Date: 2024-01-01 DOI: 10.1590/1677-5449.202400072
Jorge Luis Carrera Martínez
{"title":"Regarding the article \"Entrustable Professional Activities (EPAs) for the residency program in vascular surgery\".","authors":"Jorge Luis Carrera Martínez","doi":"10.1590/1677-5449.202400072","DOIUrl":"10.1590/1677-5449.202400072","url":null,"abstract":"","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"23 ","pages":"e20240007"},"PeriodicalIF":0.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sexual effects and long-term outcomes of endoscopic lumbar sympathectomy for plantar hyperhidrosis in men: a cross-sectional study. 内窥镜腰交感神经切除术治疗男性足底多汗症的性影响和长期疗效:一项横断面研究。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-27 eCollection Date: 2024-01-01 DOI: 10.1590/1677-5449.202400142
Marcelo de Paula Loureiro, Pietro Maran Novais, Ruimário Machado Coelho, João Augusto Nocera Paulin

Background: Plantar hyperhidrosis (PHH) is a disease with high psychosocial impact, and endoscopic lumbar sympathectomy (ELS) has been shown to be the best choice for treatment, but with some concerns such as compensatory sweating (CS) and sexual effects (SE), particularly in men.

Objectives: The aim of this study is to evaluate the long-term effectiveness of ELS for controlling PHH in men, its side effects, and perceived sexual modifications.

Methods: A cross-sectional study including only male patients operated for PHH with ELS between 2014-2022 at a private practice. During remote interviews, patients were asked about symptoms before and after ELS and about the postoperative effects on PHH. They were also objectively asked about any SE during the postoperative period. Validated quality of life for hyperhidrosis and erectile function questionnaires were also administered.

Results: 10 male patients averaging 4.26±2.86 years post-ELS were interviewed. Eight of them (80%) achieved complete response (≥80% of sweat reduction) in the first month after surgery and this response was maintained up to the interview date. Two patients had partial response. In six patients, CS occurred, with 5 reporting it as non-troublesome. Six patients reported some type of SE, but none reported erectile dysfunction. Regarding the functional results, all patients rated ELS from good (10%) to very good (30%) or excellent (60%).

Conclusions: Endoscopic lumbar sympathectomy was effective for treatment of plantar hyperhidrosis in these patients, improving their quality of life and providing lasting PHH control, with some transient sexual dysfunctions that did not impair their sexual life.

背景:足底多汗症(PHH)是一种对社会心理影响较大的疾病,内窥镜腰交感神经切除术(ELS)已被证明是治疗的最佳选择,但也存在一些问题,如代偿性出汗(CS)和性影响(SE),尤其是对男性而言:本研究旨在评估 ELS 在控制男性 PHH 方面的长期有效性、副作用以及感知到的性功能改变:方法:这是一项横断面研究,仅包括2014-2022年间在一家私人诊所接受ELS手术治疗PHH的男性患者。在远程访谈中,患者被问及 ELS 手术前后的症状以及术后对 PHH 的影响。他们还被客观地询问了术后期间的任何SE情况。此外,还对多汗症患者的生活质量和勃起功能进行了有效问卷调查:结果:10 名男性患者接受了访谈,他们术后平均勃起时间为 4.26±2.86 年。其中八名患者(80%)在术后第一个月就获得了完全应答(汗液减少≥80%),这种应答一直保持到访谈日。两名患者有部分反应。有 6 名患者出现了 CS,其中 5 名患者表示 CS 并不严重。六名患者报告了某种类型的 SE,但没有人报告勃起功能障碍。在功能结果方面,所有患者对 ELS 的评价都是从好(10%)到非常好(30%)或极好(60%):结论:内镜下腰椎交感神经切除术对这些患者的足底多汗症治疗有效,改善了他们的生活质量,持久控制了足底多汗症,一些短暂的性功能障碍不会影响他们的性生活。
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引用次数: 0
Malignant transformation of a long-term ulcer in a patient with leprosy sequelae: a case report. 麻风后遗症患者长期溃疡的恶性转化:病例报告。
IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-03 eCollection Date: 2024-01-01 DOI: 10.1590/1677-5449.202400442
Aline Gabriele Etur Dos Santos, Antônio Augusto Moreira

Marjolin's ulcer (MU) is a rare condition defined as a malignant skin tumor arising from chronic wounds and inflammation. The most common histological findings in MUs are squamous cell carcinomas (SCC) (or spinocellular carcinomas [SPC]), such as basal cell carcinomas (BCC) and malignant melanomas (MM). The aim of this study is to report the case of a patient with sequelae of leprosy who presented malignant transformation in a long-standing ulcer on the right leg, thereby contributing to understanding of the progression and significance of early diagnosis of MU. The MU was diagnosed by incisional biopsy of the lesion and upon obtaining a positive result the patient was referred to an oncology service. Treatment of MU is multidisciplinary and surgical excision is the first therapeutic option. Proper management and surveillance of chronic ulcers by the healthcare team are necessary for early recognition of MU.

马乔林溃疡(MU)是一种罕见的疾病,是由慢性伤口和炎症引起的恶性皮肤肿瘤。马乔林溃疡最常见的组织学表现是鳞状细胞癌(SCC)(或棘细胞癌[SPC]),如基底细胞癌(BCC)和恶性黑色素瘤(MM)。本研究旨在报告一例右腿长期溃疡出现恶性转化的麻风后遗症患者的病例,从而有助于了解 MU 的进展情况和早期诊断的意义。该麻风病是通过切口活组织检查确诊的,在获得阳性结果后,患者被转诊至肿瘤科。溃疡性结肠炎的治疗涉及多个学科,手术切除是首选治疗方案。医疗团队对慢性溃疡进行适当的管理和监测,对于早期识别溃疡性结肠炎十分必要。
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引用次数: 0
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Jornal Vascular Brasileiro
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