Publication: Evolución de la función renal en la cirugía abierta del aneurisma de aorta abdominal con clampaje suprarrenal
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2017-03-01
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Universidad Complutense de Madrid
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Abstract
Introducción: Desde la introducción del tratamiento endovascular (TEV) del aneurisma de aorta abdominal (AAA), hemos observado un aumento progresivo de la cirugía abierta compleja de la aorta, con un mayor uso del clampaje suprarrenal. El clampaje suprarrenal se ha relacionado con el deterioro de la función renal (DFR) durante el postoperatorio, pudiendo llevar consigo un aumento de la mortalidad precoz. Existe una gran heterogeneidad en la bibliografía en cuanto a la definición de DFR, no siendo comparables entre sí la mayoría de los estudios publicados, por lo que es preciso nuevos estudios unificando criterios. Dentro de estos criterios se podría incluir la tasa de filtrado glomerular (TFG), que es un marcador de daño renal poco utilizado en publicaciones previas, a pesar de ser a priori un marcador más sensible que la creatinina sérica. Objetivos: Los objetivos del presente trabajo de investigación son analizar los resultados de la cirugía abierta del AAA con clampaje suprarrenal a corto y medio plazo, así como evaluar la evolución de la función renal tras la misma y cuáles son los factores asociados al deterioro de la función renal en el postoperatorio...
Introduction: Since the advent of endovascular treatment (EVT) for abdominal aortic aneurysms (AAA), a progressive increase of complex aortic open surgical repair has been observed, with greater use of suprarenal cross-clamping. This maneuver has been associated with impaired postoperative renal function (IRF) leading to an increased early mortality. There is great heterogeneity among published data regarding definition of IRF, thus not being totally comparable, so further studies should be published according to unified criteria. One of these criteria could be glomerular filtrate rate (GFR), a rarely used renal damage indicator, despite being more sensitive than serum creatinine. Objectives: The aims of the present study are to analyze short and mid-term outcomes after suprarenal cross-clamping for open surgical AAA repair and the evolution of renal function and to assess the associated factors to postoperative renal function impairment. Likewise, the role of GFR as renal damage indicator is evaluated...
Introduction: Since the advent of endovascular treatment (EVT) for abdominal aortic aneurysms (AAA), a progressive increase of complex aortic open surgical repair has been observed, with greater use of suprarenal cross-clamping. This maneuver has been associated with impaired postoperative renal function (IRF) leading to an increased early mortality. There is great heterogeneity among published data regarding definition of IRF, thus not being totally comparable, so further studies should be published according to unified criteria. One of these criteria could be glomerular filtrate rate (GFR), a rarely used renal damage indicator, despite being more sensitive than serum creatinine. Objectives: The aims of the present study are to analyze short and mid-term outcomes after suprarenal cross-clamping for open surgical AAA repair and the evolution of renal function and to assess the associated factors to postoperative renal function impairment. Likewise, the role of GFR as renal damage indicator is evaluated...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 15/01/2016