Title :

A meta-analysis of outcomes of in situ reconstruction after total or partial removal of abdominal infected aortic graft

Author(s) :

Batt, Michel [Auteur]
Camou, Fabrice [Auteur]
Coffy, Amandine [Auteur]
Feugier, Patrick [Auteur]
Senneville, Eric [Auteur]
Centre Hospitalier Gustave Dron [Tourcoing]
Caillon, Jocelyne [Auteur]
Calvet, Brigitte [Auteur]
Chidiac, Christian [Auteur]
Laurent, Frédéric [Auteur]
Revest, Matthieu [Auteur]
Daures, Jean Pierre [Auteur]

Journal title :

The Journal of cardiovascular surgery

Abbreviated title :

J Cardiovasc Surg (Torino)

Publication date :

2019-01-28

ISSN :

1827-191X

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: There is currently a lack of evidence for the relative effectiveness of partial resection (PR) and total resection (TR) before managing abdominal aortic graft infection (AGI). Most authorities agree that TR is ...
Show more >BACKGROUND: There is currently a lack of evidence for the relative effectiveness of partial resection (PR) and total resection (TR) before managing abdominal aortic graft infection (AGI). Most authorities agree that TR is mandatory for intracavitary AGI in patients with favorable conditions but there is an increasing number of patients with severe comorbidities for whom this approach is not suitable, resulting in a prohibitive mortality rate. The purpose of this study was to determine the most appropriate indication for TR or PR. METHODS: A meta-analysis was conducted on the rates of early/late mortality, amputations and reinfection. A meta-regression was performed with 8 variables: patient age, male prevalence, presence of virulent or nonvirulent organisms, urgency, omentoplasty and follow-up. RESULTS: Twenty-one studies and 1.052 patients were included. For TR and PR the rates of early mortality and reinfection were 16.8% and 10.5%, 11% and 27% respectively. For TR urgency and male gender were associated with increased rate of early mortality and male gender, PDF and virulent organisms were associated with increased risk of reinfection. For PR no statistical correlation was analyzable except for PDF with increased risk of reinfection. CONCLUSIONS: Early mortality rates are higher for TR and reinfection rates are higher for PR. For TR early mortality increases in urgent cases and it is suggested that alternative option must be discussed, reinfection decreases in the presence of nonvirulent organisms and TR seems optimal. For TR and PR reinfection increases in presence of PDF and alternative technique may be more appropriate.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T16:48:25Z
2024-04-03T08:36:40Z