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Publisher: Springer Verlag
Languages: English
Types: Article
BACKGROUND: Ischaemic colitis is an infrequent but serious complication following repair of abdominal aortic aneurysm (AAA), with high mortality rates. This systematic review set out to identify risk factors for the development of ischaemic colitis after AAA surgery. METHODS: A systematic search of the MEDLINE, EMBASE and CINAHL databases was performed. This search was limited to studies published in the English language after 1990. Abstracts were screened by two authors. Eligible studies were obtained as full text for further examination. Data was extracted by two authors, and any disputes were resolved via consensus. Extracted data was pooled using Mantel-Haenszel random effects models. Bias was assessed using two Cochrane-approved tools. Effect sizes are expressed as relative risk ratios alongside the 95 % confidence interval. Statistical significance was defined at the level of p < 0.05. RESULTS: From 388 studies identified in the initial search, 33 articles were included in the final synthesis and analysis. Risk factors were grouped into patient (female gender, disease severity) and operative factors (peri-procedural hypotension, operative modality). The risk of ischaemic colitis was significantly higher when undergoing emergency repair versus elective (risk ratio (RR) 7.36, 3.08 to 17.58, p < 0.001). Endovascular repair reduced the likelihood of ischaemic colitis (RR 0.22, 0.12 to 0.39, p < 0.001). DISCUSSION: The quality of published evidence on this subject is poor with many retrospective datasets and inconsistent reporting across studies. Despite this, emergency presentation and open repair should prompt close monitoring for the development of IC.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Waton S, Johal A, Groene I, Cromwell D, Mitchell D, Loftus I (2013) Outcomes after Elective Repair of Infra-renal Abdominal Aortic Aneurysm. Royal College of Surgeons of England, London
    • 2. Mitchell D, Hindley H, Naylor R, Wyatt M, Loftus I (2012) Outcomes after Elective Repair of Infrarenal Abdominal Aortic Aneurysm. Vascular Society of Great Britain and Ireland, London
    • 3. Sinha S, Ata Ozdemir B, Khalid U, Karthikesalingam A, Poloniecki JD, Thompson MM, Holt PJ (2014) Failure-to-rescue and interprovider comparisons after elective abdominal aortic aneurysm repair. Br J Surg 101 (12):1541-1550. doi:10.1002/bjs.9633
    • 4. Steele SR (2007) Ischemic colitis complicating major vascular surgery. Surg Clin North Am 87 (5):1099-1114, ix. doi:10.1016/j.suc.2007.07.007
    • 5. Fitridge RA, Boult M, Mackillop C, De Loryn T, Barnes M, Cowled P, Thompson MM, Holt PJ, Karthikesalingam A, Sayers RD, Choke E, Boyle JR, Forbes TL, Novick TV (2015) International trends in patient selection for elective endovascular aneurysm repair: sicker patients with safer anatomy leading to improved 1-year survival. Ann Vasc Surg 29 (2):197-205. doi:10.1016/j.avsg.2014.09.015
    • 6. Sterne J, Higgins J, Reeves B (2014) A Cochrane Risk Of Bias Assessment Tool: for Non-Randomized Studies of Interventions (ACROBAT- NRSI). http://www.riskofbias.info Accessed 08/12/2015
    • 7. Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, Cochrane Bias Methods G, Cochrane Statistical Methods G (2011) The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 343:d5928. doi:10.1136/bmj.d5928
    • 8. Senekowitsch C, Assadian A, Assadian O, Hartleb H, Ptakovsky H, Hagmuller GW (2006) Replanting the inferior mesentery artery during infrarenal aortic aneurysm repair: influence on postoperative colon ischemia. J Vasc Surg 43 (4):689-694. doi:10.1016/j.jvs.2005.12.016
    • 9. Perry RJ, Martin MJ, Eckert MJ, Sohn VY, Steele SR (2008) Colonic ischemia complicating open vs endovascular abdominal aortic aneurysm repair. J Vasc Surg 48 (2):272-277. doi:10.1016/j.jvs.2008.03.040
    • 10. Becquemin JP, Majewski M, Fermani N, Marzelle J, Desgrandes P, Allaire E, Roudot-Thoraval F (2008) Colon ischemia following abdominal aortic aneurysm repair in the era of endovascular abdominal aortic repair. J Vasc Surg 47 (2):258-263; discussion 263. doi:10.1016/j.jvs.2007.10.001
    • 11. Bjorck M, Lindberg F, Broman G, Bergqvist D (2000) pHi monitoring of the sigmoid colon after aortoiliac surgery. A five-year prospective study. Eur J Vasc Endovasc Surg 20 (3):273-280. doi:10.1053/ejvs.2000.1148
    • 12. Jarvinen O, Laurikka J, Sisto T, Tarkka M (1996) Intestinal ischemia following surgery for aortoiliac disease. Vasa 25 (2):148-155
    • 13. Neary P, Hurson C, Briain DO, Brabazon A, Mehigan D, Keaveny TV, Sheehan S (2007) Abdominal aortic aneurysm repair and colonic infarction: a risk factor appraisal. Colorectal Dis 9 (2):166-172. doi:10.1111/j.1463-1318.2006.01149.x
    • 14. Bjorck M, Troeng T, Bergqvist D (1997) Risk Factors for Intestinal Ischaemia after Aortoiliac Surgery: a Combined Cohort and Case-control Study of 2824 Operations Eur J Vasc Endovasc Surg 13:531-539
    • 15. Megalopoulos A, Vasiliadis K, Tsalis K, Kapetanos D, Bitzani M, Tsachalis T, Batziou E, Botsios D (2008) Reliability of Selective Surveillance Colonoscopy in the Early Diagnosis of Colonic Ischemia After Successful Ruptured Abdominal Aortic Aneurysm Repair. Vasc Endovascular Surg 41
    • 16. Longo W, Lee T, Barnett M, Vernava A, Wade T, Petersen G, Jacobs D, Virgo K, Johnson F (1996) Ischemic Colitis Complicating Abdominal Aortic Aneurysm Surgery in the U.S. Veteran. J Surg Res 60:351-354
    • 17. Van Damme H, Creemers E, Limet R (2000) Ischaemic Colitis following Aortoiliac. Acta Chir Belg 100 (1):21-27
    • 18. Champagne BJ, Darling RC, 3rd, Daneshmand M, Kreienberg PB, Lee EC, Mehta M, Roddy SP, Chang BB, Paty PS, Ozsvath KJ, Shah DM (2004) Outcome of aggressive surveillance colonoscopy in ruptured abdominal aortic aneurysm. J Vasc Surg 39 (4):792-796. doi:10.1016/j.jvs.2003.12.002
    • 19. Dadian N, Ohki T, Veith FJ, Edelman M, Mehta M, Lipsitz EC, Suggs WD, Wain RA (2001) Overt colon ischemia after endovascular aneurysm repair: the importance of microembolization as an etiology. J Vasc Surg 34 (6):986-996. doi:10.1067/mva.2001.119241
    • 20. Levison J, Halpern V, Kline R, Faust G, Cohen J (1999) Perioperative predictors of colonic 25. Mehta M, Byrne WJ, Robinson H, Roddy SP, Paty PS, Kreienberg PB, Feustel P, Darling RC, 3rd (2012) Women derive less benefit from elective endovascular aneurysm repair than men. J Vasc Surg 55 (4):906-913. doi:10.1016/j.jvs.2011.11.047
    • 26. Prinnsen M, Verhoeven E, Buth J, Cuypers P, van Sambeek M, Balm R, Buskens E, Grobbee D, Blankenstejn J (2004) A Randomized Trial Comparing Conventional and Endovascular Repair of Abdominal Aortic Aneurysms. N Eng J Med 351:1607-1618
    • 27. Welch M, Baguneid M, McMahon R, Dodd P, Fulford P, Griffiths G, Walker M (1998) Histological study of colonic ischaemia after aortic surgery. Br J Surg 85:1095-1098
    • 28. Toya N, Baba T, Kanaoka Y, Ohki T (2014) Embolic complications after endovascular repair of abdominal aortic aneurysms. Surgery Today 44:1893-1899
    • 29. Geraghty PJ, Sanchez LA, Rubin BG, Choi ET, Flye MW, Curci JA, Thompson RW, Sicard GA (2004) Overt ischemic colitis after endovascular repair of aortoiliac aneurysms. J Vasc Surg 40 (3):413-418. doi:10.1016/j.jvs.2004.05.022
    • 30. Karch LA, Hodgson KJ, Mattos MA, Bohannon WT, Ramsey DE, McLafferty RB (2000) Adverse consequences of internal iliac artery occlusion during endovascular repair of abdominal aortic aneurysms. J Vasc Surg 32 (4):676-683. doi:10.1067/mva.2000.109750
    • 31. Schoder M, Zaunbauer L, Holzenbein T, Fleischmann D, Cejna M, Kretschmer, Thurnher S, Lammer J (2001) Internal Iliac Artery Embolization Before Endovascular Repair of Abdominal Aortic Aneurysms: Frequency, Efficacy, and Clinical Results. Am J Roent 177:599-605
    • 32. Wolpert L, Dittrich K, Hallisey M, Almendinger P, Gallagher J, Heydt K, Lowe R, Windels M, Drezner A (2001) Hypogastric artery embolization in endovascular abdominal aortic aneurysm repair. . J Vasc Surg 33:1193-1198
    • 33. Mehta M, Veith FJ, Ohki T, Cynamon J, Goldstein K, Suggs WD, Wain RA, Chang D, Freidman S, Scher L, Lipsitz E (2001) Unilateral and bilateral hypogastric artery interruption during aortoiliac aneurysm repair in 154 patients: a relatively innocuous procedure. J Vasc Surg 33:s27-32
    • 34. Woo EY, Ullery BW, Carpenter JP, Wang GJ, Fairman RM, Jackson BM (2011) Open abdominal aortic aneurysm repair is feasible and can be done with excellent results in octogenarians. J Vasc Surg 53 (2):278-284. doi:10.1016/j.jvs.2010.08.061
    • 35. Menegaux F, Tresallet C, Kieffer E, Bodin L, Thabut D, Rouby J (2006) Aggressive Management of Nonocclusive Ischemic Colitis Following Aortic Reconstruction. Arch Surg 141
    • 36. Hansman MF, Neuzil D, Quigley TM, Hauptmann E, Fotoohi M, Robinson D, Raker EJ (2003) A comparison of 50 initial endoluminal endograft repairs for abdominal aortic aneurysm with 50 concurrent open repairs. The American Journal of Surgery 185 (5):441-444. doi:10.1016/s0002- 9610(03)00053-9
    • 37. Jarvinen O, Laurikka J, Salaenius J, Lepantalo M (1999) Mesenteric infarction after aortoiliac surgery on the basis of 1752 operations from the National Vascular Registry. . World J Surg 23:243-247
    • 38. Maldonado TS, Rockman CB, Riles E, Douglas D, Adelman MA, Jacobowitz GR, Gagne PJ, Nalbandian MN, Cayne NS, Lamparello PJ, Salzberg SS, Riles TS (2004) Ischemic complications after endovascular abdominal aortic aneurysm repair. J Vasc Surg 40 (4):703-709. doi:10.1016/j.jvs.2004.07.032
    • 39. Cao P, Verzini F, Parlani G, Romano L, De Rango P, Pagliuca V, Iacono G (2004) Clinical effect of abdominal aortic aneurysm endografting: 7-year concurrent comparison with open repair. J Vasc Surg 40 (5):841-848. doi:10.1016/j.jvs.2004.08.040
    • 40. Coppi G, Silingardi R, Gennai S, Saitta G, Ciardullo AV (2006) A single-center experience in open and endovascular treatment of hemodynamically unstable and stable patients with ruptured abdominal aortic aneurysms. J Vasc Surg 44 (6):1140-1147. doi:10.1016/j.jvs.2006.08.070
    • 41. Roberts K, Revell M, Youssef H, Bradbury AW, Adam DJ (2006) Hypotensive resuscitation in patients with ruptured abdominal aortic aneurysm. Eur J Vasc Endovasc Surg 31 (4):339-344. doi:10.1016/j.ejvs.2005.11.003
    • 42. Powell JT, Hinchliffe RJ, Thompson MM, Sweeting MJ, Ashleigh R, Bell R, Gomes M, Greenhalgh RM, Grieve RJ, Heatley F, Thompson SG, Ulug P (2014) Observations from the IMPROVE trial concerning the clinical care of patients with ruptured abdominal aortic aneurysm. Br J Surg 101 (3):216-224; discussion 224. doi:10.1002/bjs.9410
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