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The impact of endovascular repair of ruptured abdominal aortic aneurysm on the gastrointestinal and renal function.

Makar RR, Badger SA, O'Donnell ME, Soong CV, Lau LL, Young IS, Hannon RJ, Lee B - Int J Vasc Med (2014)

Bottom Line: Paracetamol absorption was increased in eEVAR group at day 3 compared to day 1 (P = 0.03), with no similar result in eOR (P = 0.24).Clinical intestinal function returned quicker in eEVAR (P = 0.02).Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Vascular and Endovascular Surgery Unit, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, UK.

ABSTRACT
Introduction. Systemic effects of ruptured abdominal aortic aneurysm (rAAA) may be altered by the mode of surgery. This study aimed to determine systemic effects of endovascular aneurysm repair (EVAR) compared to open repair (OR). Patients and Methods. Consecutive patients with rAAA were repaired by OR or EVAR according to computerised tomographic (CT) findings. Renal function was monitored by estimated glomerular filtration rate (eGFR), serum urea and creatinine, and urinary albumin creatinine ratio (ACR). Hepatic function was assessed postoperatively for 5 days. Intestinal function was determined by the paracetamol absorption test. Intestinal permeability was assessed by urinary lactulose/mannitol ratio. Results. 30 rAAA patients were included. Fourteen had eEVAR and sixteen eOR. Serum urea were higher in eOR, while creatinine was similar between groups. Hepatic function showed no intergroup difference. Paracetamol absorption was increased in eEVAR group at day 3 compared to day 1 (P = 0.03), with no similar result in eOR (P = 0.24). Peak lactulose/mannitol ratio was higher in eOR (P = 0.03), with higher urinary L/M ratio in eOR at day 3 (P = 0.02). Clinical intestinal function returned quicker in eEVAR (P = 0.02). Conclusion. EVAR attenuated the organ dysfunction compared to open repair. However, a larger comparative trial would be required to validate this. The clinical trial is registered with reference number EUDRACT: 2013-003373-12.

No MeSH data available.


Related in: MedlinePlus

Serum creatinine concentrations in the eEVAR versus eOR groups at PO (P = 0.755), D1 (P = 0.493), D2 (P = 0.333), D3 (P = 0.645), D4 (P = 0.810), D5 (P = 0.549), and the peak (P = 0.467) expressed as median and IQR (Mann-Whitney U test).
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fig2: Serum creatinine concentrations in the eEVAR versus eOR groups at PO (P = 0.755), D1 (P = 0.493), D2 (P = 0.333), D3 (P = 0.645), D4 (P = 0.810), D5 (P = 0.549), and the peak (P = 0.467) expressed as median and IQR (Mann-Whitney U test).

Mentions: Serum creatinine were similar throughout in the eEVAR and the eOR groups (Figure 2). However, a significant rise in serum creatinine was observed in the eOR group at D1 compared to the PO level (P = 0.02), with no difference within the eEVAR group between the PO and any of the postoperative time points (P > 0.05). There was a weak correlation between the peak serum creatinine concentration and the volume of intraoperative packed-cells transfused (r = 0.382; P = 0.03) and the Hardman's scores (r = 0.391; P = 0.03).


The impact of endovascular repair of ruptured abdominal aortic aneurysm on the gastrointestinal and renal function.

Makar RR, Badger SA, O'Donnell ME, Soong CV, Lau LL, Young IS, Hannon RJ, Lee B - Int J Vasc Med (2014)

Serum creatinine concentrations in the eEVAR versus eOR groups at PO (P = 0.755), D1 (P = 0.493), D2 (P = 0.333), D3 (P = 0.645), D4 (P = 0.810), D5 (P = 0.549), and the peak (P = 0.467) expressed as median and IQR (Mann-Whitney U test).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3927867&req=5

fig2: Serum creatinine concentrations in the eEVAR versus eOR groups at PO (P = 0.755), D1 (P = 0.493), D2 (P = 0.333), D3 (P = 0.645), D4 (P = 0.810), D5 (P = 0.549), and the peak (P = 0.467) expressed as median and IQR (Mann-Whitney U test).
Mentions: Serum creatinine were similar throughout in the eEVAR and the eOR groups (Figure 2). However, a significant rise in serum creatinine was observed in the eOR group at D1 compared to the PO level (P = 0.02), with no difference within the eEVAR group between the PO and any of the postoperative time points (P > 0.05). There was a weak correlation between the peak serum creatinine concentration and the volume of intraoperative packed-cells transfused (r = 0.382; P = 0.03) and the Hardman's scores (r = 0.391; P = 0.03).

Bottom Line: Paracetamol absorption was increased in eEVAR group at day 3 compared to day 1 (P = 0.03), with no similar result in eOR (P = 0.24).Clinical intestinal function returned quicker in eEVAR (P = 0.02).Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Vascular and Endovascular Surgery Unit, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, UK.

ABSTRACT
Introduction. Systemic effects of ruptured abdominal aortic aneurysm (rAAA) may be altered by the mode of surgery. This study aimed to determine systemic effects of endovascular aneurysm repair (EVAR) compared to open repair (OR). Patients and Methods. Consecutive patients with rAAA were repaired by OR or EVAR according to computerised tomographic (CT) findings. Renal function was monitored by estimated glomerular filtration rate (eGFR), serum urea and creatinine, and urinary albumin creatinine ratio (ACR). Hepatic function was assessed postoperatively for 5 days. Intestinal function was determined by the paracetamol absorption test. Intestinal permeability was assessed by urinary lactulose/mannitol ratio. Results. 30 rAAA patients were included. Fourteen had eEVAR and sixteen eOR. Serum urea were higher in eOR, while creatinine was similar between groups. Hepatic function showed no intergroup difference. Paracetamol absorption was increased in eEVAR group at day 3 compared to day 1 (P = 0.03), with no similar result in eOR (P = 0.24). Peak lactulose/mannitol ratio was higher in eOR (P = 0.03), with higher urinary L/M ratio in eOR at day 3 (P = 0.02). Clinical intestinal function returned quicker in eEVAR (P = 0.02). Conclusion. EVAR attenuated the organ dysfunction compared to open repair. However, a larger comparative trial would be required to validate this. The clinical trial is registered with reference number EUDRACT: 2013-003373-12.

No MeSH data available.


Related in: MedlinePlus