背景:1型神经纤维瘤病是一种常染色体显性疾病,其特征是咖啡斑和神经纤维瘤,以及骨骼中的各种其他症状,眼睛,和神经系统。由于它与血管脆性有关,据报道,1型神经纤维瘤病与血管病变有关,如动脉瘤。然而,很少有与1型神经纤维瘤病相关的腹部内脏动脉瘤的报道。此外,目前尚无机器人治疗1型神经纤维瘤病相关动脉瘤的报道.在这份报告中,我们描述了一例1型神经纤维瘤病伴脾动脉瘤的患者,该患者通过机器人手术成功治疗。
方法:本报告描述了一名41岁的亚洲女性,有1型神经纤维瘤病病史,她被转诊到我院进行腹部超声观察的28毫米脾动脉瘤评估。动脉瘤在脾门,尝试了经导管动脉栓塞术;然而,由于脾动脉弯曲,这很困难。因此,我们建议微创机器人手术治疗和切除脾动脉瘤并保留脾脏。术后进展顺利,患者在术后第八天出院。随访1年,病人情况很好,没有复发的证据.
结论:我们在1例1型神经纤维瘤病用机器人手术成功治疗的患者中遇到一例罕见的脾动脉瘤病例。关于神经纤维瘤病相关动脉瘤的治疗方式尚无共识,血管内治疗被认为是安全有效的;然而,手术仍然是一种重要的治疗方式。尤其是血流动力学状态稳定的患者,机器人手术可以被认为是决定性的治疗。据我们所知,这是1例1型神经纤维瘤病患者成功治疗的脾动脉瘤病例。
BACKGROUND: Neurofibromatosis type 1 is an autosomal-dominant disease characterized by café-au-lait spots and neurofibromas, as well as various other symptoms in the bones, eyes, and nervous system. Due to its connection with vascular fragility, neurofibromatosis type 1 has been reported to be associated with vascular lesions, such as aneurysms. However, there have been few reports of abdominal visceral aneurysms associated with neurofibromatosis type 1. Furthermore, there have been no reports of robotic treatment of aneurysms associated with neurofibromatosis type 1. In this report, we describe the case of a patient with neurofibromatosis type 1 with a splenic artery aneurysm who was successfully treated with robotic surgery.
METHODS: This report describes a 41-year-old Asian woman with a history of neurofibromatosis type 1 who was referred to our hospital for evaluation of a 28 mm splenic artery aneurysm observed on abdominal ultrasound. The aneurysm was in the splenic hilum, and transcatheter arterial embolization was attempted; however, this was difficult due to the tortuosity of the splenic artery. Thus, we suggested minimally invasive robotic surgery for treatment and resection of the splenic artery aneurysm with preservation of the spleen. The postoperative course was uneventful, and the patient was discharged on the eighth day after surgery. At 1 year of follow-up, the patient was doing well, with no evidence of recurrence.
CONCLUSIONS: We encountered a rare case of splenic artery aneurysm in a patient with neurofibromatosis type 1 who was successfully treated with robotic surgery. There is no consensus on treatment modalities for neurofibromatosis-related aneurysms, and endovascular treatment is considered safe and effective; however, surgery remains an important treatment modality. Especially in patients with stable hemodynamic status, robotic surgery may be considered as definitive treatment. To our knowledge, this is the first successfully treated case of a splenic artery aneurysm in a patient with neurofibromatosis type 1.