The value of routine flexible sigmoidoscopy within 48 hours after surgical repair of ruptured abdominal aortic aneurysms
| Autor: | Jesper Laustsen, Mikkel Tøttrup, Anders P. Tøttrup, Anette Marianne Fedder, Reinhold Jensen |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Necrosis Aortic Rupture Denmark Ischemia Severity of Illness Index Aortic aneurysm Blood Vessel Prosthesis Implantation Postoperative Complications medicine Humans Aortic rupture Survival rate Sigmoidoscopy Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Diagnostic Tests Routine Retrospective cohort study General Medicine Middle Aged medicine.disease Surgery Survival Rate Treatment Outcome Female medicine.symptom Cardiology and Cardiovascular Medicine business Colitis Ischemic Abdominal surgery Aortic Aneurysm Abdominal Follow-Up Studies |
| Zdroj: | Tøttrup, M, Fedder, A M, Jensen, R H, Tøttrup, A & Laustsen, J 2013, ' The Value of Routine Flexible Sigmoidoscopy Within 48 Hours After Surgical Repair of Ruptured Abdominal Aortic Aneurysms ', Annals of Vascular Surgery, vol. 7, no. 6, pp. 714-718 . https://doi.org/10.1016/j.avsg.2012.07.030 |
| ISSN: | 1615-5947 |
| DOI: | 10.1016/j.avsg.2012.07.030 |
| Popis: | Left-sided colonic and rectal ischemia is commonly seen after surgery for ruptured abdominal aortic aneurysms (rAAAs) and is associated with increased mortality. Earlier studies have shown that flexible sigmoidoscopy (FS) may detect ischemia when performed postoperatively, and suggestions have been made that patients can be selected for FS based on clinical and biochemical parameters. We sought to perform FS in all patients surviving the first 24 hours after surgery for rAAA and to compare the findings of FS to clinical and biochemical parameters.All patients undergoing emergency surgery for rAAA and surviving the first 24 hours underwent FS to assess any degree of ischemia.During the study period, 41 patients survived the first 24 hours after surgery. In 9 (22%) patients, some degree of colonic ischemia was found. Segmental necrosis was only shown in 5% at first FS. Patients with ischemia received more blood transfusions intraoperatively than those with normal findings at FS. They also had longer periods with mean blood pressure60 mm Hg postoperatively, and lower arterial pH on the first postoperative day. Blood lactate levels did not differ between the groups. None of the parameters were sufficiently discriminative to be used for distinguishing between patients with and without ischemia.Severe colonic ischemia was less common than previously reported. All cases of colonic ischemia were identified by early FS, but none of the clinical and biochemical parameters were sufficiently reliable to distinguish between patients with and without ischemia. It is suggested that all patients initially surviving surgery for rAAA should be offered FS to screen for colonic ischemia. |
| Databáze: | OpenAIRE |
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