新光醫院急診科招募R1住院醫師-衛福部106年度容額

新光醫院急診醫學科105年5月份醫師晨間研討會

日期		主題	報告者	指導者
05/02	一	tPA & IA Thrombectomy	葉旭霖醫師/神經內科
05/03	二	Painkyl®（Fentanyl Buccal Soluble Film）＆Thrombocytopenia專題講座	賴泓誌醫師
05/04	三	區域醫院急診陷阱	曾理銘醫師
		北區急診聯合影像討論會（Abdominal Lesion）	翁健瑞醫師
05/09	一	醫護討論會 （自拔管＆遊民24hrs Holter事件）	連楚明醫師＆劉玉香護理長
05/10	二	血友病診斷及治療	林立偉＆周聖傑醫師
05/11	三	ER-GS聯合晨會	李俊毅	連楚明
05/16	一	Mortality＆Morbidity	高睿詩 許昕璘 李岱穎	洪世文
05/17	二	ER-Rad.聯合晨會	林秋梅＆刁翠美醫師
05/18	三	北區急診聯合病例討論會	北榮急診主辦
05/23	一	Special Lecture	張志華醫師
05/24	二	Case Conference	謝宜庭			楊毓錚
05/25	三	Radiographic Examination in Pregnancy	陳欣伶醫師
05/30	一	急診福爾摩斯案例討論會	林立偉醫師
05/31	二	72hrs回診個案討論	林哲葦 蔡宇承		許瓅文

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Endovascular vs. Open Repair of Ruptured AAA

Endovascular vs. Open Repair of Ruptured Abdominal Aortic Aneurysms

Allan S. Brett, MD Reviewing Reimerink JJ et al., Ann Surg 2013 Aug 258:248

In a randomized Dutch trial, outcomes were similar with the two procedures.

Although catheter-based endovascular aneurysm repair (EVAR) was introduced initially as a less invasive alternative to open surgery for elective repair of abdominal aortic aneurysms (AAAs), EVAR also has been used in cases of ruptured AAAs. Researchers in Amsterdam compared open repair and EVAR in this study of 395 patients with ruptured AAAs. During the study (2004–2011), an effort was made to treat all patients in Amsterdam with ruptured AAAs at the three hospitals involved in the trial.

Anatomy was suitable for EVAR in 155 patients, 116 of whom ultimately were randomized to EVAR or open repair. The incidence of the primary composite endpoint — death or severe complications at 30 days — was not significantly different in the two groups (42% vs. 47%; P=0.58). Taken separately, each of the primary endpoint components occurred with similar frequency in the EVAR and open-repair groups. Rates of death and serious complications remained similar in the treatment groups at 6 months.

COMMENT:
Among patients with ruptured abdominal aortic aneurysms and anatomy suitable for endovascular repair, outcomes with endovascular repair and open repair were similar. However, this study was conducted in a community where experienced centers were organized to offer around-the-clock emergency intervention for ruptured AAAs. August 27, 2013