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Postoperative fever, bowel ischaemia and cytokine response to abdominal aortic aneurysm repair--a comparison between endovascular and open surgery

Syk, Ingvar LU ; Brunkwall, J; Ivancev, Krassi LU ; Lindblad, Bengt LU ; Montgomery, Agneta LU ; Wellander, E; Wisniewski, J and Risberg, B (1998) In European Journal of Vascular and Endovascular Surgery 15(5). p.398-405
Abstract
OBJECTIVES: To study bowel ischaemia in transfemorally placed endoluminal grafting (TPEG) for abdominal aortic aneurysms, and any relation to cytokine response or postoperative fever. DESIGN: Prospective not randomised. University hospital setting. MATERIAL: Fourteen cases of conventional surgery and 23 cases of endovascular technique for infrarenal abdominal aortic aneurysm repair. METHODS: Tonometry was used for sigmoid colon pH, and ELISAs for serum IL-6. RESULTS: Mucosal pH in the sigmoid colon fell significantly during clamping and reperfusion in both groups. Lowest measured sigmoid colon pH was 7.10 in the open group, compared to 7.22 in the TPEG group (p < 0.05). The IL-6 levels in serum peaked after 4 h of reperfusion; 249 pg/ml... (More)
OBJECTIVES: To study bowel ischaemia in transfemorally placed endoluminal grafting (TPEG) for abdominal aortic aneurysms, and any relation to cytokine response or postoperative fever. DESIGN: Prospective not randomised. University hospital setting. MATERIAL: Fourteen cases of conventional surgery and 23 cases of endovascular technique for infrarenal abdominal aortic aneurysm repair. METHODS: Tonometry was used for sigmoid colon pH, and ELISAs for serum IL-6. RESULTS: Mucosal pH in the sigmoid colon fell significantly during clamping and reperfusion in both groups. Lowest measured sigmoid colon pH was 7.10 in the open group, compared to 7.22 in the TPEG group (p < 0.05). The IL-6 levels in serum peaked after 4 h of reperfusion; 249 pg/ml in the open group, compared to 89 pg/ml in the TPEG group (p < 0.05). High levels of IL-6 in the postoperative period and persisting low sigmoidal pH were associated with serious complications. Postoperative temperature did not differ significantly between the groups, and no significant correlation could be found with sigmoid colon pH or IL-6 levels. CONCLUSIONS: The less pronounced perioperative bowel ischaemia in TPEG patients indicates an advantage of the TPEG technique. Splanchnic ischaemia was not related to postoperative fever, nor the IL-6 or TNF response. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Vascular surgery, Endoluminal grafts, Cytokines, Ischaemia, Fever
in
European Journal of Vascular and Endovascular Surgery
volume
15
issue
5
pages
398 - 405
publisher
Elsevier
external identifiers
  • pmid:9633494
  • scopus:0031809522
ISSN
1532-2165
language
English
LU publication?
yes
id
372d3a56-a145-4236-bdb0-f5576a077d3f (old id 1112953)
alternative location
http://www.journals.elsevierhealth.com/periodicals/yejvs/article/PIIS1078588498802001/abstract
date added to LUP
2008-07-14 09:20:34
date last changed
2017-10-08 04:11:07
@article{372d3a56-a145-4236-bdb0-f5576a077d3f,
  abstract     = {OBJECTIVES: To study bowel ischaemia in transfemorally placed endoluminal grafting (TPEG) for abdominal aortic aneurysms, and any relation to cytokine response or postoperative fever. DESIGN: Prospective not randomised. University hospital setting. MATERIAL: Fourteen cases of conventional surgery and 23 cases of endovascular technique for infrarenal abdominal aortic aneurysm repair. METHODS: Tonometry was used for sigmoid colon pH, and ELISAs for serum IL-6. RESULTS: Mucosal pH in the sigmoid colon fell significantly during clamping and reperfusion in both groups. Lowest measured sigmoid colon pH was 7.10 in the open group, compared to 7.22 in the TPEG group (p &lt; 0.05). The IL-6 levels in serum peaked after 4 h of reperfusion; 249 pg/ml in the open group, compared to 89 pg/ml in the TPEG group (p &lt; 0.05). High levels of IL-6 in the postoperative period and persisting low sigmoidal pH were associated with serious complications. Postoperative temperature did not differ significantly between the groups, and no significant correlation could be found with sigmoid colon pH or IL-6 levels. CONCLUSIONS: The less pronounced perioperative bowel ischaemia in TPEG patients indicates an advantage of the TPEG technique. Splanchnic ischaemia was not related to postoperative fever, nor the IL-6 or TNF response.},
  author       = {Syk, Ingvar and Brunkwall, J and Ivancev, Krassi and Lindblad, Bengt and Montgomery, Agneta and Wellander, E and Wisniewski, J and Risberg, B},
  issn         = {1532-2165},
  keyword      = {Vascular surgery,Endoluminal grafts,Cytokines,Ischaemia,Fever},
  language     = {eng},
  number       = {5},
  pages        = {398--405},
  publisher    = {Elsevier},
  series       = {European Journal of Vascular and Endovascular Surgery},
  title        = {Postoperative fever, bowel ischaemia and cytokine response to abdominal aortic aneurysm repair--a comparison between endovascular and open surgery},
  volume       = {15},
  year         = {1998},
}