Interleukin-6 production is reduced by the extraperitoneal approach in elective abdominal aortic aneurysm repair

Lau, Luk; Halliday, Margaret; Lee, Bernard T.; Hannon, R.J.; Gardiner, Keith; Soong, Chee V.

doi:10.1055/s-0031-1276293

Cited by 2 publications

(3 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…26 In support of these observations, reduced intestinal permeability, endotoxemia, and interleukin (IL)-6 formation have been observed in patients undergoing RP compared with TP repair. 27,28 By focusing on the temporal kinetics of CRP release (an acute-phase reactant with a half-life of 19 hours, 29 synthesized and secreted by the liver and regulated almost exclusively by IL-6 30 ) our data further extend these findings and suggest that the operative trauma incurred during RP repair was less pronounced. The dedicated focus on CRP was predicated by its established sensitivity and specificity as an independent risk factor, 31 predictor, 32 and prognostic biomarker 33 in the setting of AAA disease and repair.…”

Section: Discussionsupporting

confidence: 64%

See 1 more Smart Citation

Retroperitoneal Compared to Transperitoneal Approach for Open Abdominal Aortic Aneurysm Repair Is Associated with Reduced Systemic Inflammation and Postoperative Morbidity

et al. 2022

View full text Add to dashboard Cite

Background In the United Kingdom, the most common surgical approach for repair of open abdominal aortic aneurysms (AAAs) is transperitoneal (TP). However, retroperitoneal (RP) approach is favored in those with more complex vascular anatomy often requiring a cross-clamp on the aorta superior to the renal arteries. This study compared these approaches in patients matched on all major demographic, comorbid, anatomic, and physiological variables. Methods Fifty-seven patients (TP: n = 24; RP: n = 33) unsuitable for endovascular aneurysm repair underwent preoperative cardiopulmonary exercise testing prior to open AAA repair. The surgical approach undertaken was dictated by individual surgeon preference. Postoperative mortality, complications, and length of hospital stay (LoS) were recorded. Patients were further stratified according to infrarenal (IR) or suprarenal/supraceliac (SR/SC) surgical clamping. Systemic inflammation (C-reactive protein) and renal function (serum creatinine and estimated glomerular filtration rate) were recorded. Results Twenty-three (96%) of TP patients only required an IR clamp compared with 12 (36%) in the RP group. Postoperative systemic inflammation was lower in RP patients (p = 0.002 vs. TP) and fewer reported pulmonary/gastrointestinal complications whereas renal impairment was more marked in those receiving SR/SC clamps (p < 0.001 vs. IR clamp). RP patients were defined by lower LoS (p = 0.001), while mid-/long-term mortality was low/comparable with TP, resulting in considerable cost savings. Conclusion Despite the demands of more complicated vascular anatomy, the clinical and economic benefits highlighted by these findings justify the more routine adoption of the RP approach for complex AAA repair.

show abstract

Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Retroperitoneal Compared to Transperitoneal Approach for Open Abdominal Aortic Aneurysm Repair Is Associated with Reduced Systemic Inflammation and Postoperative Morbidity

et al. 2022

View full text Add to dashboard Cite

show abstract

“…N-acetyl cysteine, atrial natriuretic peptide, prostaglandin, theophylline have been used in a number of studies [25] [26] [27][28]. To provide postoperative AKD, off-pump cardiac surgery technique[29] [30] and an extraperitoneal approach to aortic surgery[31] have been researched previously. Studies looked at the effects of hydration fluids[32] [33][34].…”

mentioning

confidence: 99%

Renal Outcomes and Myocardial Performance after On-Pump Beating Heart versus Conventional On-Pump Surgery in Patients with Preoperative Low Glomerular Filtration Rate

Çolak¹,

Azboy²,

Temizturk³

et al. 2016

WJCD

View full text Add to dashboard Cite

Objective: Acute kidney disease develops 16%-30% of patients with preoperative impaired renal functions. Our aim of this study was to compare postoperative renal outcomes using two open heart surgery techniques, on-pump beating heart (OPBH) and conventional on-pump (COP), in patients who have preoperative low glomerular filtration rate (eGFR) as an indicator of creatinine clearance. Methods: From 2004 to 2015, 341 patients with preoperative creatinine clearance were lower than 90 ml/min/1.73m 2 were selected for this study. On-Pump beating heart was performed in 111 patients (Group I). Conventional on-pump technique was used in 200 patients. In the remaining patients, we measured postoperative Tumor Necrosis Factor Alpha (TNF-alpha), cardiac troponin I (cTn-I), Brain natriuretic peptid (NT-Pro-BNP), creatinine (Cr), blood urea nitrogen (BUN) and postoperative eGFR daily until day four after surgery. Results: There were no differences in baseline levels of TNF-alpha, NT-Pro-BNP, BUN, cTn-I, Cr levels between the groups. Cardiopulmonary bypass (CPB) time were much longer and cumulative inotrope use was significantly higher in patients underwent COP (P < 0.05). Postoperative TNF-alpha and c-TnI was significantly higher in group II (P < 0.001).

show abstract

Interleukin-6 production is reduced by the extraperitoneal approach in elective abdominal aortic aneurysm repair

Cited by 2 publications

References 14 publications

Retroperitoneal Compared to Transperitoneal Approach for Open Abdominal Aortic Aneurysm Repair Is Associated with Reduced Systemic Inflammation and Postoperative Morbidity

Retroperitoneal Compared to Transperitoneal Approach for Open Abdominal Aortic Aneurysm Repair Is Associated with Reduced Systemic Inflammation and Postoperative Morbidity

Renal Outcomes and Myocardial Performance after On-Pump Beating Heart versus Conventional On-Pump Surgery in Patients with Preoperative Low Glomerular Filtration Rate

Contact Info

Product

Resources

About