Risk Factors of Postoperative Intestinal Ischemia After Abdominal Aortic Aneurysm Repair

Willemsen, Saskia I.; Berge, M. Ten; Eps, Randolph van; Veger, Hugo T.C.; Overhagen, Hans van; Dijk, Lukas van; Wever, Jan J.

doi:10.1016/j.ejvs.2019.06.920

Cited by 1 publication

(2 citation statements)

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“…Numerous reports in the literature have already supported IC being a significant risk factor for death. 2,28,29 With routine endoscopic surveillance, our surgical intervention rate of 7.9% was not increased when compared to other similar studies (3.9 to 14.5%). 9,10,26,27,30 Surgical intervention after rAAA repair portends a poor outcome given that 5 of 9 patients after abdominal exploration died.…”

Section: Mortalitycontrasting

confidence: 41%

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Detection of Ischemic Colitis on Routine Lower Endoscopy and Its Implications After Repair of Ruptured Abdominal Aortic Aneurysm

Kim

Slipak

Webber

et al. 2022

The American Surgeon™

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Background Ischemic colitis (IC) is a known significant complication after repair of a ruptured abdominal aortic aneurysm (rAAA). Lower endoscopy (colonoscopy or flexible sigmoidoscopy) is a helpful adjunct to aid decision making for surgical exploration. We believe routine use of lower endoscopy after rAAA repair provides better patient care through expeditious diagnosis and surgical care. Methods We performed a retrospective chart review of rAAA repairs from 2008 to 2019. All patients undergo screening lower endoscopy after rAAA repair at our institution. The incidence of IC, mortality, and diagnostic characteristics of routine lower endoscopy was analyzed. Results Of these, 182 patients underwent rAAA repair, among which 139 (76%) underwent routine lower endoscopy. Ischemic colitis of any grade was diagnosed in 25% of patients. The 30-day mortality was 11% compared to 19% in those without lower endoscopy. The presence of IC portended a 4-fold increase in mortality rate compared to those without (26% vs 6%, P = .005). Surgical exploration rate was 8% after routine lower endoscopy. Grade III ischemia on lower endoscopy had a sensitivity of 50% (95% CI 12-88) and specificity of 99% (95% CI 94-100) for transmural necrosis. Discussion We found increased incidence of IC and reliable diagnostic characteristics of routine lower endoscopy in predicting the presence of transmural colonic ischemia. There was decreased mortality with use of routine lower endoscopy but this was not statistically significant.

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Section: Mortalitycontrasting

confidence: 41%

“…Numerous reports in the literature have already supported IC being a significant risk factor for death. 2,28,29…”

Section: Discussionmentioning

confidence: 99%

Detection of Ischemic Colitis on Routine Lower Endoscopy and Its Implications After Repair of Ruptured Abdominal Aortic Aneurysm

Kim

Slipak

Webber

et al. 2022

The American Surgeon™

View full text Add to dashboard Cite

show abstract

Risk Factors of Postoperative Intestinal Ischemia After Abdominal Aortic Aneurysm Repair

Cited by 1 publication

References 3 publications

Detection of Ischemic Colitis on Routine Lower Endoscopy and Its Implications After Repair of Ruptured Abdominal Aortic Aneurysm

Detection of Ischemic Colitis on Routine Lower Endoscopy and Its Implications After Repair of Ruptured Abdominal Aortic Aneurysm

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