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Simultaneous Gastrointestinal Surgery in Patients With Elective Abdominal Aortic Reconstruction
An Additional Risk Factor?
Thomas Luebke, MD;
Ulrich Wolters, MD, PhD;
Michael Gawenda, MD;
Jan Brunkwall, MD, PhD;
Arnulf H. Hoelscher, MD, FACS, FRCS
Arch Surg. 2002;137:143-147.
Hypothesis The management of simultaneously occurring intra-abdominal abnormalities and abdominal aortic aneurysms or aortoiliac occlusive disease is controversial. The aim of this retrospective study was to analyze whether gastrointestinal operations performed at the same time as aortic repair increase the postoperative morbidity and mortality rate.
Method Between January 1, 1989, and December 31, 1997, a total of 42 patients underwent open aortic tube (n = 33) or bifurcated grafting (n = 9) and simultaneous surgery of 1 or more gastrointestinal abnormalities. In a matched-pairs analysis for each of the aforementioned patients, a control patient with an exclusive aortic procedure was selected. For each matched pair the following aspects were noted: the type of operative procedure, time of execution, duration of the surgical procedure, the duration of postoperative ventilatory assistance, intensive care unit and hospital stays, the number of blood units transfused, the use of antibiotics, and the main postoperative complications.
Results The comparison between the matched pairs revealed no statistically significant difference for postoperative morbidity or mortality rate or length of intensive care unit and hospital stays. There were no operative or hospital deaths. None of the patients has (median follow-up, 68 months) shown evidence of graft infection.
Conclusion A 1-stage operation management is feasible if appropriate care is given to the technical details and if the rules of antisepsis are followed.
From the Department of Visceral and Vascular Surgery, University of Cologne, Cologne, Germany.
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