Sökning: onr:"swepub:oai:DiVA.org:uu-421186" > Abdominal compartme...
Fältnamn | Indikatorer | Metadata |
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000 | 04737nam a2200469 4500 | |
001 | oai:DiVA.org:uu-421186 | |
003 | SwePub | |
008 | 201009s2020 | |||||||||||000 ||eng| | |
020 | a 9789151310299q print | |
024 | 7 | a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4211862 URI |
040 | a (SwePub)uu | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a vet2 swepub-contenttype |
072 | 7 | a dok2 swepub-publicationtype |
100 | 1 | a Ersryd, Samuelu Uppsala universitet,Kärlkirurgi4 aut0 (Swepub:uu)samer255 |
245 | 1 0 | a Abdominal compartment syndrome and colonic ischaemia after abdominal aortic aneurysm repair in the endovascular era |
264 | 1 | a Uppsala :b Acta Universitatis Upsaliensis,c 2020 |
300 | a 96 s. | |
338 | a electronic2 rdacarrier | |
490 | 0 | a Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine,x 1651-6206 ;v 1689 |
520 | a Abdominal Compartment Syndrome (ACS) and colonic ischaemia (CI) are serious and potentially lethal complications after open (OSR) and endovascular repair (EVAR) of ruptured (rAAA) and intact (iAAA) abdominal aortic aneurysms. The aims of this thesis were to investigate the incidence, outcome, and risk factors associated with ACS (Papers I-III) and to evaluate extraluminal colonic tonometry for postoperative surveillance of colonic perfusion (Paper IV).Papers I-III combined data from the nationwide Swedish vascular registry (Swedvasc) (2008-2015) with case records and radiologic imaging. Paper I investigated incidence and outcome of ACS. The incidence was approximately 7% for both EVAR and OSR after rAAA and 1.6% after OSR and 0.5% after EVAR for iAAA. ACS was associated with a more than two-fold (59% vs 27%) 90-day mortality after rAAA and six-fold (19% vs 3%) after iAAA. Paper II investigated risk factors and outcome among subgroups. Risk of death could not be attributed to a specific main pathology of ACS: CI, postoperative bleeding and general oedema, nor to timing of decompressive laparotomy in relation to AAA surgery. However, the duration of intra-abdominal hypertension (IAH) predicted the need for renal replacement therapy. Paper III investigated risk factors after EVAR for rAAA. ACS was rare without pronounced pre- or intraoperative physiologic derangement associated with circulatory instability. Aortic morphology did not impact ACS development, nor did presence of a patent inferior mesenteric and lumbar arteries, known risk factors for type II endoleak. Paper IV studied patients operated on for iAAA/rAAA (n=27), and demonstrated extraluminal colonic tonometry safe, reliable and indicative of CI among all affected patients (n=4).In conclusion, ACS was common after rAAA repair, with poor outcome irrespective of AAA repair technique and indication for repair. Outcome did not differ depending on the main pathophysiological finding associated with ACS development, while a longer duration of IAH increased the risk of renal replacement therapy. ACS after EVAR for rAAA was largely associated with pre- and intraoperative physiologic factors. These findings highlight the importance of vigilant intra-abdominal pressure measurement after rAAA repair and in case of haemodynamic instability, as well as timely interventions to treat IAH. Extraluminal colonic tonometry appears promising for surveillance of postoperative colonic perfusion. | |
650 | 7 | a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kirurgi0 (SwePub)302122 hsv//swe |
650 | 7 | a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Surgery0 (SwePub)302122 hsv//eng |
653 | a Aortic aneurysm-abdominal | |
653 | a Intra-abdominal pressure | |
653 | a Intra-abdominal hypertension | |
653 | a Abdominal compartment syndrome | |
653 | a Rupture | |
653 | a Open ab-domen treatment | |
653 | a Colonic ischaemia | |
653 | a Endovascular aneurysm repair | |
653 | a Surgery | |
653 | a Kirurgi | |
700 | 1 | a Wanhainen, Andersu Uppsala universitet,Kärlkirurgi4 ths0 (Swepub:uu)anwan103 |
700 | 1 | a Björck, Martinu Uppsala universitet,Kärlkirurgi4 ths0 (Swepub:uu)mabjo425 |
700 | 1 | a Djavani, Khaterehu Uppsala universitet,Kärlkirurgi,Centrum för klinisk forskning, Gävleborg4 ths0 (Swepub:uu)khadj328 |
700 | 1 | a Albäck, Anders,c Associate Professoru Department of vascular surgery, Helsinki University Hospital, Helsinki University4 opn |
710 | 2 | a Uppsala universitetb Kärlkirurgi4 org |
856 | 4 | u https://uu.diva-portal.org/smash/get/diva2:1474678/FULLTEXT01.pdfx primaryx Raw objecty fulltext |
856 | 4 | u https://uu.diva-portal.org/smash/get/diva2:1474678/PREVIEW01.jpgx Previewy preview image |
856 | 4 8 | u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-421186 |
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