Postoperative fever, bowel ischaemia and cytokine response to abdominal aortic aneurysm repair — a comparison between endovascular and open surgery
| Autor: | E. Wellander, Agneta Montgomery, Bengt Lindblad, Jan Brunkwall, J Wisniewski, Krassi Ivancev, Bo Risberg, Ingvar Syk |
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| Rok vydání: | 1998 |
| Předmět: |
Male
medicine.medical_specialty Fever Manometry Ischemia Enzyme-Linked Immunosorbent Assay Bowel ischaemia Ischaemia Blood Vessel Prosthesis Implantation Postoperative fever Postoperative Complications Colon Sigmoid medicine Humans Prospective Studies Splanchnic Circulation Intestinal Mucosa Aged Medicine(all) Aged 80 and over Interleukin-6 Tumor Necrosis Factor-alpha business.industry Sigmoid colon Perioperative Hydrogen-Ion Concentration Middle Aged Vascular surgery medicine.disease Constriction digestive system diseases Abdominal aortic aneurysm Surgery C-Reactive Protein medicine.anatomical_structure Anesthesia Reperfusion Cytokines Female Cardiology and Cardiovascular Medicine business Splanchnic Endoluminal grafts Aortic Aneurysm Abdominal |
| Zdroj: | European Journal of Vascular and Endovascular Surgery. 15:398-405 |
| ISSN: | 1078-5884 |
| Popis: | OBJECTIVES: To study bowel ischaemia in transfemorally placed endoluminal grafting (TPEG) for abdominal aortic aneurysms, and any relation to cytokine response or postoperative fever. DESIGN: Prospective not randomised. University hospital setting. MATERIAL: Fourteen cases of conventional surgery and 23 cases of endovascular technique for infrarenal abdominal aortic aneurysm repair. METHODS: Tonometry was used for sigmoid colon pH, and ELISAs for serum IL-6. RESULTS: Mucosal pH in the sigmoid colon fell significantly during clamping and reperfusion in both groups. Lowest measured sigmoid colon pH was 7.10 in the open group, compared to 7.22 in the TPEG group (p < 0.05). The IL-6 levels in serum peaked after 4 h of reperfusion; 249 pg/ml in the open group, compared to 89 pg/ml in the TPEG group (p < 0.05). High levels of IL-6 in the postoperative period and persisting low sigmoidal pH were associated with serious complications. Postoperative temperature did not differ significantly between the groups, and no significant correlation could be found with sigmoid colon pH or IL-6 levels. CONCLUSIONS: The less pronounced perioperative bowel ischaemia in TPEG patients indicates an advantage of the TPEG technique. Splanchnic ischaemia was not related to postoperative fever, nor the IL-6 or TNF response. (Less) |
| Databáze: | OpenAIRE |
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