Does the degree of calcification of the celiac trunk and superior mesenteric artery on preoperative computerized tomography predict the risk of anastomotic leak after right colectomy? A single center retrospective study

Postaire, Boris; Abet, E.; Montigny, Philippe; Vent, Pierre-Alexandre

doi:10.1016/j.jviscsurg.2018.10.006

Cited by 5 publications

(7 citation statements)

References 15 publications

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“…The clinical significance of aortic calcium scores and abdominal arteries has not been widely studied in the literature. A few authors studied atheroma as a risk factor for anastomosis leakage [19][20][21][22]25] or as being associated with the diameter of the main bile duct [26]. Our study suggests that among the abdominal arteries, calcifications of the superior mesenteric artery were the most strongly associated with mortality.…”

Section: Discussionmentioning

confidence: 62%

Atherosclerosis is associated with poorer outcome in non-occlusive mesenteric ischemia

Juif¹,

Calame²,

Winiszewski³

et al. 2021

European Journal of Radiology

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To evaluate whether abdominal atherosclerosis was associated with poorer outcome in a single-centre cohort of patients suffering from nonocclusive mesenteric ischemia (NOMI). Methods: From January 2009 to December 2019, 121 consecutive patients from the critical care unit who underwent laparotomy for suspected NOMI and with available unenhanced and contrast-enhanced CT were included. Clinical and biological data at the time of the CT scan were retrospectively extracted from medical charts and reviewed by a single radiologist. Unenhanced CT acquisitions were used to calculate calcium scores of the abdominal aorta, celiac trunk, superior mesenteric artery (SMA) and common iliac arteries according to the Agatston method. Univariate and multivariate analysis were performed. Results: Among the 121 patients with NOMI and calcium score calculation, only 4 patients had no aortic calcifications (3 %) and 32 had no superior mesenteric artery calcification (26 %). 35 patients (29 %) died within 24 h after the abdominal CT scan. Univariate analysis showed that a total abdominal calcium score greater than 15 000 (last quartile) was significantly associated with death within 24 h (14 (40 %) vs 17 (20 %) patients, p = 0.035). By multivariate analysis, a total abdominal calcium score greater than 15 000 was an independent risk factor for death (HR = 1.94,, p = 0.044). Regarding separate calcium scores, only a SMA calcium score greater than 50 was a risk factor for death (HR 2.46,, p = 0.019). Conclusion:Our results show that abdominal atherosclerosis, especially in the SMA, is associated with poorer outcome in NOMI.

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Section: Discussionmentioning

confidence: 62%

Atherosclerosis is associated with poorer outcome in non-occlusive mesenteric ischemia

Juif¹,

Calame²,

Winiszewski³

et al. 2021

European Journal of Radiology

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“…However, no association was found with mesenteric artery (SMA) stenosis. 28 Kornmann et al could not confirm these findings using a similar scoring method in patients who underwent colorectal surgery. 18 Secondly, two of the five studies in subcategory B considered the total amount of calcification.…”

Section: Subcategory Bmentioning

confidence: 93%

“…Methodological item for non--randomized studies Boersema 19 Eveno 27 Komen 16 Kornmann 18 Lee 29 Pochhammer 26 Postaire 28 Shen 17 The maximum score is 24 points. 0 = not reported, 1 = reported but not adequate, 2 = adequate reported; A MINORS score of 12< was considered to be poor-, 12-17 was moderate-and >17 was good methodological quality -6 - For the 500 HU analysis, univariate analysis did not show significant differences in patient characteristics or vascular trajectories.…”

Section: Methodological Item For Non--randomized Studies (Minors) Scorementioning

confidence: 99%

“…In most (n=4) of these papers, vascular calcification was associated with anastomotic leakage after colorectal surgery (Table I). 17,[27][28][29] In addition, three of the five studies considered calcified-associated stenosis of evaluated trajectories by CT scan. The grade of stenosis was classified as either no stenosis, <50% stenosis or ≥50% stenosis.…”

Section: Subcategory Bmentioning

confidence: 99%

“…Boersema 19 Eveno 27 Komen 16 Kornmann 18 Lee 29 Pochhammer 26 Postaire 28 Shen firmed. This might be explained by the collateral vascularization of the colon and rectum, i.e., the mesenteric arteries, iliac arteries and marginal artery of the colon.…”

Section: No Anastomotic Leakage Groupmentioning

confidence: 99%

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Calcification of the Aorta-Iliac Trajectory as a Risk Factor for Anastomotic Leakage in Colorectal Surgery: Individual Patient Data Meta-Analysis and Systematic Review

Edomskis

Menon

et al. 2021

Surg Technol Int.

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Objective: The purpose of this review is to evaluate the relevance of vascular calcification as a potential risk factor for anastomotic leakage in colorectal surgery. Method: The Embase, Medline, PubMed, and Cochrane databases and Google Scholar were systematically searched. Studies that assessed calcification of the aorta-iliac trajectory in patients who underwent colorectal surgery were included. An independent patient data meta-analysis was performed as follows: based on the heterogeneity of the study population, a “random-effects model” or “fixed-effects model” was used to perform a multivariable logistic regression and calculate pooled Odds Ratios (OR) and 95% confidence intervals (CI). Heterogeneity was assessed using the Q-test and I2-test. Results: From a total of 457 articles retrieved, eight fell within the scope of the review, with a total of 2010 patients. Anastomotic leakage was found at a mean rate of 11.1% (SD 4.9%). In these eight studies, four different calcification scoring methods were used, which made a single structured meta-analysis not feasible. Therefore, an independent patient data meta-analysis on the most frequently used calcification scoring method was performed, including three studies with a total of 396 patients. After multivariable analyses, no significant association was found between anastomotic leakage and the amount of calcification in the aorta-iliac trajectory. The remaining three scoring methods were evaluated. In four of the five studies, vascular calcification was associated with anastomotic leakage after colorectal surgery. Conclusion: In contrast to previous studies, an individual patient data meta-analysis found no association between calcification and anastomotic leakage in colorectal surgery after multivariable analysis that considered a single calcification measurement method. In addition, this study demonstrated several scoring methods for arterial calcification and the need for a standardized technique. Therefore, the authors would recommend prospective studies using a calcification scoring method that includes grade of stenosis due to its potential to preoperatively improve perfusion by endovascular treatment.

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Is abdominal vascular calcification score valuable in predicting the occurrence of colorectal anastomotic leakage? A meta-analysis

Tong

Xie

Song

et al. 2020

Int J Colorectal Dis

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Does the degree of calcification of the celiac trunk and superior mesenteric artery on preoperative computerized tomography predict the risk of anastomotic leak after right colectomy? A single center retrospective study

Cited by 5 publications

References 15 publications

Atherosclerosis is associated with poorer outcome in non-occlusive mesenteric ischemia

Atherosclerosis is associated with poorer outcome in non-occlusive mesenteric ischemia

Calcification of the Aorta-Iliac Trajectory as a Risk Factor for Anastomotic Leakage in Colorectal Surgery: Individual Patient Data Meta-Analysis and Systematic Review

Is abdominal vascular calcification score valuable in predicting the occurrence of colorectal anastomotic leakage? A meta-analysis

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