Simultaneous Gastrointestinal Surgery in Patients With Elective Abdominal Aortic Reconstruction

Luebke, Thomas; Wolters, U; Gawenda, M.; Brunkwall, Jan; Hoelscher, Arnulf H.

doi:10.1001/archsurg.137.2.143

Cited by 14 publications

(9 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5, 9, 10 Unfortunately, we were unable to obtain further details on the nature of the interventions included in the other abdominal procedures group as we do not know what procedures were performed. Nevertheless, the fact that these procedures were associated with such a clear increase in perioperative mortality warrants careful deliberation by the surgeon when considering performing any additional abdominal procedure during open AAA repair.…”

Section: Discussionmentioning

confidence: 99%

“…By sparing the need for a second procedure, outcomes may improve, while total hospital stay and costs decrease. 5, 7 However, clinicians are generally hesitant to attempt one-stage procedures, 4, 5, 8 as evidence supporting the safety and feasibility of contemporaneous procedures is largely lacking.…”

Section: Introductionmentioning

confidence: 99%

“…3, 4, 6 Several studies have assessed the benefits of a combined procedure over a sequential approach for concomitant nonvascular intra-abdominal disease with mixed conclusions and recommendations. 5, 9-12 With up to one-third of AAA patients suffering from renal artery stenoses and a prevalence of peripheral artery disease (PAD) of over 50%, 13-16 occlusive vascular disease in particular is often present in the AAA population. Despite this high prevalence, the safety and feasibility of concurrent surgical treatments remain largely unclear.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The perioperative effect of concomitant procedures during open infrarenal abdominal aortic aneurysm repair

Ultee

Soden

Zettervall

et al. 2016

Journal of Vascular Surgery

View full text Add to dashboard Cite

Introduction Open repair of abdominal aortic aneurysms (AAA) is occasionally performed in conjunction with additional procedures. However, it is unclear how these concomitant procedures affect outcome. This study aims to determine the frequency of additional procedures during elective open AAA repair and the impact on perioperative outcomes. Methods Between January 2003 and November 2014, all elective infrarenal open AAA repairs in the Vascular Study Group of New England (VSGNE) were identified. Patients were grouped by concomitant procedures, which included: no concomitant procedure, renal artery bypass, lower extremity bypass, other abdominal procedure or thrombo-embolectomy. Analyses were performed using multivariable logistic regression. Results 1314 patients underwent elective AAA repair, of whom 153 (11.6%) had a concomitant procedure, including renal bypass 27 (2.1%), lower extremity bypass 28 (2.1%), other abdominal procedures 64 (4.9%), and thrombo-embolectomy 48 (3.7%). Independent risk factors for 30-day mortality were renal bypass (OR: 7.2, 95% CI: 1.9 – 27.7), other abdominal procedures (OR: 4.8, 95% CI: 1.6 – 14.1) and thrombo-embolectomy (OR: 8.8, 95% CI: 3.1 – 24.9). Deterioration of renal function was predicted by renal bypass (OR: 5.1, 95% CI: 2.1–12.4) and thrombo-embolectomy (OR: 3.7, 95% CI: 1.8 – 7.6). Lower extremity bypass and thrombo-embolectomy were predictive of postoperative leg ischemia (OR: 8.9, 95% CI: 2.7 – 29.0; OR: 11.2, 95% CI: 4.4 – 28.8, respectively), while thrombo-embolectomy was also predictive of postoperative myocardial infarction (OR: 4.4, 95% CI: 1.6 – 12.0). Conclusions Performing additional procedures during infrarenal open AAA repair is associated with increased morbidity and mortality in the postoperative period. Careful deliberation of both the operative risks and the necessity of the additional interventions are therefore advised during operative planning. This study also highlights the importance of avoiding perioperative thrombo-embolic events.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The perioperative effect of concomitant procedures during open infrarenal abdominal aortic aneurysm repair

Ultee

Soden

Zettervall

et al. 2016

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…The question was whether to repair first the AAA aneurysm and perform the double transplantation at a later time, or to perform all three procedures in the same operative session. The argument against the first option is that the repair of an AAA in a patient affected by end-stage liver and kidney disease carries a higher risk of mortality and morbidity than in patients affected only by AAA (17)(18)(19). Moreover, the use of a vascular prosthesis could be associated with the potential risk of infection during the subsequent transplant procedures or later as a result of the immunosuppressive therapy (20).…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Orthotopic Liver and Kidney Transplant with Repair of Abdominal Aortic Aneurysm: Operative Timing

Testa¹,

Panaro²,

Bogetti³

et al. 2003

American Journal of Transplantation

View full text Add to dashboard Cite

In the case of coexisting abdominal aortic aneurysm (AAA) and liver/renal failure, the controversial issue is the timing of the AAA repair and the transplantation of the affected organs. The question is whether to repair the AAA first and perform the double transplantation at a later time, or to perform all three procedures in the same operative session. This patient was affected by hepatic/renal failure and had also developed AAA. We describe the operative strategies utilized to perform the cadaver donor and recipient operations in this setting. In our patient, a combined liver/kidney transplantation with simultaneous aneurysm repair using arterial allografts was successfully performed. In a patient affected by end-stage liver, kidney, and aneurysmatic disease, a simultaneous liver/kidney transplant and AAA repair may represent the safest and most efficient treatment solution.

show abstract

“…Many authors have reported excellent results in patients who have undergone open AAA repair combined with surgery for intraabdominal malignancies [1][2][3][4][5][6]. However, pancreatic resection concomitant with open AAA repair has rarely been performed due to concerns about graft infection following pancreatic leakage and the poor prognosis of pancreatic neoplasms [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

A one-stage operation for abdominal aortic aneurysm and intraductal papillary mucinous neoplasms of the pancreas: report of a case

Tsuji¹,

Kitano²,

Sawada³

2012

Surg Today

View full text Add to dashboard Cite

Pancreatic surgery concomitant with abdominal aortic repair is rarely chosen due to concerns about prosthetic infection following pancreatic leakage and the poor prognosis of pancreatic neoplasms. We herein report a successfully treated case of infrarenal abdominal aortic aneurysm and intraductal papillary mucinous neoplasms of the pancreas treated by a one-stage operation. A 75-year-old male with a history of cerebral infarction and chronic subdural hematoma was referred to our department with a pulsatile abdominal mass. A 70-mm infrarenal abdominal aortic aneurysm with severe proximal neck angulation and a 28-mm multilocular cystic tumor with mural nodules in the pancreas body were detected. Abdominal aortic repair with a prosthetic graft and distal pancreatectomy were performed simultaneously. The postoperative course was mostly uneventful, and he was discharged to a rehabilitation facility.

show abstract

Simultaneous Gastrointestinal Surgery in Patients With Elective Abdominal Aortic Reconstruction

Cited by 14 publications

References 23 publications

The perioperative effect of concomitant procedures during open infrarenal abdominal aortic aneurysm repair

The perioperative effect of concomitant procedures during open infrarenal abdominal aortic aneurysm repair

Simultaneous Orthotopic Liver and Kidney Transplant with Repair of Abdominal Aortic Aneurysm: Operative Timing

A one-stage operation for abdominal aortic aneurysm and intraductal papillary mucinous neoplasms of the pancreas: report of a case

Contact Info

Product

Resources

About