scholarly journals The Impact of Endovascular Repair of Ruptured Abdominal Aortic Aneurysm on the Gastrointestinal and Renal Function

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
R. R. Makar ◽  
S. A. Badger ◽  
M. E. O’Donnell ◽  
C. V. Soong ◽  
L. L. Lau ◽  
...  
Keyword(s):  
Renal Function ◽  
Abdominal Aortic Aneurysm ◽  
Open Repair ◽  
Hepatic Function ◽  
Systemic Effects ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Intestinal Function ◽  
Serum Urea ◽  
Abdominal Aortic ◽  
Paracetamol Absorption

Introduction. Systemic effects of ruptured abdominal aortic aneurysm (rAAA) may be altered by the mode of surgery. This study aimed to determine systemic effects of endovascular aneurysm repair (EVAR) compared to open repair (OR).Patients and Methods. Consecutive patients with rAAA were repaired by OR or EVAR according to computerised tomographic (CT) findings. Renal function was monitored by estimated glomerular filtration rate (eGFR), serum urea and creatinine, and urinary albumin creatinine ratio (ACR). Hepatic function was assessed postoperatively for 5 days. Intestinal function was determined by the paracetamol absorption test. Intestinal permeability was assessed by urinary lactulose/mannitol ratio.Results. 30 rAAA patients were included. Fourteen had eEVAR and sixteen eOR. Serum urea were higher in eOR, while creatinine was similar between groups. Hepatic function showed no intergroup difference. Paracetamol absorption was increased in eEVAR group at day 3 compared to day 1 (P=0.03), with no similar result in eOR (P=0.24). Peak lactulose/mannitol ratio was higher in eOR (P=0.03), with higher urinary L/M ratio in eOR at day 3 (P=0.02). Clinical intestinal function returned quicker in eEVAR (P=0.02).Conclusion. EVAR attenuated the organ dysfunction compared to open repair. However, a larger comparative trial would be required to validate this. The clinical trial is registered with reference number EUDRACT: 2013-003373-12.

The revascularization technique does not impact renal function after proximal abdominal aortic aneurysm open repair

2021 ◽  
Vol 62 (1) ◽  
Author(s):  
Daniele MASCIA ◽  
Alessandro GRANDI ◽  
Luca BERTOGLIO ◽  
Andrea KAHLBERG ◽  
Concetta SARACINO ◽  
...  
Keyword(s):  
Renal Function ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Open Repair ◽  
Abdominal Aortic

Outcomes following endovascular or open repair for ruptured abdominal aortic aneurysm in a Chinese population

2013 ◽  
Vol 29 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Chao-Ying Wu ◽  
Chih-Yang Chan ◽  
Shu-Chien Huang ◽  
Nai-Shin Chi ◽  
Shoei-Shen Wang ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Chinese Population ◽  
Open Repair ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Abdominal Aortic

scholarly journals Routine open abdomen treatment compared with on-demand open abdomen or direct closure following open repair of ruptured abdominal aortic aneurysms: A propensity score–matched study

2019 ◽  
Vol 7 ◽  
pp. 205031211983350 ◽  
Author(s):  
Kristian Smidfelt ◽  
Joakim Nordanstig ◽  
Urban Wingren ◽  
Göran Bergström ◽  
Marcus Langenskiöld
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Propensity Score ◽  
Open Abdomen ◽  
Open Repair ◽  
Matched Control ◽  
University Hospital ◽  
Control Group ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Abdominal Aortic

Objective: To investigate whether a strategy of treatment with a primarily open abdomen improves outcome in terms of mortality and major complications in patients treated with open repair for a ruptured abdominal aortic aneurysm compared to a strategy of primary closure of the abdomen. Design: Retrospective cohort study. Methods: Patients treated with a primarily open abdomen at a centre where this strategy was routine in most ruptured abdominal aortic aneurysm patients were compared to a propensity score–matched control group of patients who had the abdomen closed at the end of the primary operation in a majority of the cases. Results: In total, 79 patients treated with a primarily open abdomen after open repair for ruptured abdominal aortic aneurysm at Sahlgrenska University Hospital were compared to a propensity score–matched control group of 148 patients. The abdomen was closed at the end of the procedure in 108 (73%) of the control patients. There was no difference in 30-day mortality between patients treated with a primarily open abdomen at Sahlgrenska University Hospital and the controls, 21 (26.6%) versus 49 (33.1%), p = 0.37. The adjusted odds ratio for mortality at 30 days was 0.66 (95% confidence interval: 0.35–1.25) in patients treated with a primarily open abdomen at Sahlgrenska University Hospital compared to the controls. No difference was observed between the groups regarding 90-day mortality, postoperative renal failure requiring renal replacement therapy, postoperative intestinal ischaemia necessitating bowel resection or postoperative bleeding requiring reoperation. Conclusions: The study did not show any survival advantage or difference in major complications between patients treated with a primarily open abdomen after open repair for ruptured abdominal aortic aneurysm and propensity-matched controls where the abdomen was primarily closed in a majority of the cases.

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