Colonic epithelial apoptosis during conventional and endoluminal aortic surgery

Ghosh, Jonathan; Khwaja, Nadeem; Howarth, V. S.; Murray, David; Murphy, Maureen; Byers, Richard; Walker, Michael G.

doi:10.1002/bjs.4902

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…There were also significant rises in peripheral pro-inflammatory cytokines including tumour necrosis factor a compared with no evidence of apoptosis and much lower cytokine release following EVAR. 43 In the case of EVAR, a possible cause of CI is occlusion of the IMA. The effect of this on CI is unclear but is commonly performed in both EVAR and OR.…”

Section: Discussionmentioning

confidence: 99%

Elective Repair of Abdominal Aortic Aneurysm and the Risk of Colonic Ischaemia: Systematic Review and Meta-Analysis

Williamson

Ambler

Twine

et al. 2018

European Journal of Vascular and Endovascular Surgery

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Section: Discussionmentioning

confidence: 99%

Elective Repair of Abdominal Aortic Aneurysm and the Risk of Colonic Ischaemia: Systematic Review and Meta-Analysis

Williamson

Ambler

Twine

et al. 2018

European Journal of Vascular and Endovascular Surgery

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“…(10,11,21,30). To assess the involvement of oxidative and (23) (35,36 (38,39), the liver (40), the coronary sinus (41,42) …”

Section: Cell Activationmentioning

confidence: 99%

Early Renal Ischemia-Reperfusion Injury in Humans Is Dominated by IL-6 Release from the Allograft

Vries

Lindeman

Tsikas

et al. 2009

American Journal of Transplantation

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The pathophysiology of ischemia/reperfusion (I/R) injury is complex, and current knowledge of I/R injury in humans is incomplete. In the present study, human living-donor kidney transplantation was used as a highly reproducible model to systematically study various processes potentially involved in early I/R injury. Unique, direct measurements of arteriovenous concentration differences over the kidney revealed massive release of interleukin (IL)-6 in the first 30 minutes of graft reperfusion and a modest release of IL-8. Among the assessed markers of oxidative and nitrosative stress, only 15(S)-8-iso-PGF 2a was released. When assessing cell activation, release of prothrombin factor 1 + 2 indicated thrombocyte activation, whereas there was no release of markers for endothelial activation or neutrophil activation. Common complement activation complex sC5b-9 was not released into the bloodstream, but was released into urine rapidly after reperfusion. To investigate whether IL-6 plays a modulating role in I/R injury, a mouse experiment of renal I/R injury was performed. Neutralizing anti-IL-6 antibody treatment considerably worsened kidney function. In conclusion, this study shows that renal I/R in humans is dominated by local IL-6 release. Neutralization of IL-6 in mice resulted in a significant aggravation of renal I/R injury.

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“…Older age, female gender, ruptured aneurysm, emergency surgery, prolonged surgery, aortic clamping duration, and previous cardiovascular history were associated with an increased risk of IC [5,15,17,20,21]. On the contrary, EVAR surgery was found to be protective towards IC compared to open aortic surgery probably due to lower ischemia-reperfusion injury and peripheral proinflammatory cytokine release [16,22,23].…”

Section: Introductionmentioning

confidence: 99%

Predictors of mortality following emergency open colectomy for ischemic colitis: a single-center experience

et al. 2020

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Background: Ischemic colitis (IC) is a severe emergency in gastrointestinal surgery. The aim of the present study was to identify the predictors of postoperative mortality after emergent open colectomy for IC treatment. Additionally, we compared postoperative outcomes of patients undergoing emergent colectomy due to aortic surgery-related IC (AS-IC group) vs. other IC etiologies (Other-IC group). Methods: We analyzed records of consecutive patients who underwent emergency open colectomy for IC between 2008 and 2019. Logistic regression analysis was performed to identify clinical and operative parameters associated with postoperative mortality. The AS-IC and Other-IC groups were compared for mortality, morbidity, ICU stay, hospital stay, and survival. Results: During the study period, 94 patients (mean age, 67.4 ± 13.7 years) underwent emergent open colectomy for IC. In the majority of cases, IC involved the entire colon (53.2%) and vasopressor agents were required preoperatively (63.8%) and/or intraoperatively (78.8%). Thirty-four patients underwent surgery due to AS-IC, whereas 60 due to Other-IC causes. In the AS-IC group, 9 patients had undergone endovascular aortic repair and 25 open aortic surgery; 61.8% of patients needed aortic surgery for ruptured abdominal aortic aneurism (AAA). Overall, 66 patients (70.2%) died within 90 days from surgery. The AS-IC and Other-IC groups showed similar operative outcomes and postoperative complication rates. However, the duration of the ICU stay (19 days vs. 11 days; p = 0.003) and of the total hospital stay (22 days vs. 16 days; p = 0.016) was significantly longer for the AS-IC group than for the Other-IC group. The rate of intestinal continuity restoration at 1 year after surgery was higher for the Other-IC group than for the AS-IC group (58.8% vs. 22.2%; p = 0.05). In the multivariate model, preoperative increased lactate levels, a delay between signs/symptoms' onset and surgery > 12 h, and the occurrence of postoperative acute kidney injury were statistically associated with postoperative mortality. Neither IC etiology (aortic surgery vs. other etiology) nor ruptured AAA was associated with postoperative mortality. Conclusion: Emergency open colectomy for IC is associated with high postoperative mortality, which appears to be unrelated to the IC etiology. Preoperative lactate levels, > 12-h delay to surgery, and postoperative acute kidney injury are independent predictors of postoperative mortality.

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Colonic epithelial apoptosis during conventional and endoluminal aortic surgery

Abstract: The lack of columnar epithelial apoptosis following EVAR reflects the relatively minor ischaemic injury incurred during this procedure.

Cited by 6 publications

References 26 publications

Elective Repair of Abdominal Aortic Aneurysm and the Risk of Colonic Ischaemia: Systematic Review and Meta-Analysis

Elective Repair of Abdominal Aortic Aneurysm and the Risk of Colonic Ischaemia: Systematic Review and Meta-Analysis

Early Renal Ischemia-Reperfusion Injury in Humans Is Dominated by IL-6 Release from the Allograft

Predictors of mortality following emergency open colectomy for ischemic colitis: a single-center experience

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