Abstract
Introduction: Recognition of acute mesenteric ischaemia (AMesI) in patients with aortic dissection (AoD) may be a challenge and exploratory laparotomy is often performed. Methods: We retrospectively analysed our experience with the use of diagnostic laparoscopy (DL) for the early detection of AMesI in patients with AoD, either undergoing medical treatment or after open/endovascular interventions. Results: Between 2004 and 2011, 202 consecutive AoDs were treated in our centre (71 acute type A AoD; 131 acute and chronic type B AoD). Among the 17 (8.4%) patients in which AMesI was suspected, nine (52.9%) were selected for DL. Three DLs were performed during medical treatment of patients with acute type B AoD, six after treatment of AoD (both surgical and endovascular). Three second-look DLs were also performed. Eight DLs were negative, three showed AMesI and the patients underwent successful emergent revascularisation. One DL was not conclusive and laparotomy was required. Among the eight patients not submitted to DL, one case of bowel infarction was recorded. Conclusions: In our series DL was feasible and safe. The low invasiveness and repeatability were the main advantages. Although additional experience is mandatory, DL seems a promising technique for the detection of AMesI in patients with AoD.
| Original language | English |
|---|---|
| Pages (from-to) | 690-697 |
| Number of pages | 8 |
| Journal | European Journal of Vascular and Endovascular Surgery |
| Volume | 43 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 2012 |
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Keywords
- Acute mesenteric ischaemia
- Aortic dissection
- Diagnosis
- Laparoscopy
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
Cite this
Diagnostic laparoscopy for early detection of acute mesenteric ischaemia in patients with aortic dissection. / Tshomba, Y.; Coppi, G.; Marone, E. M.; Bertoglio, L.; Kahlberg, A.; Carlucci, M.; Chiesa, R.
In: European Journal of Vascular and Endovascular Surgery, Vol. 43, No. 6, 06.2012, p. 690-697.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diagnostic laparoscopy for early detection of acute mesenteric ischaemia in patients with aortic dissection
AU - Tshomba, Y.
AU - Coppi, G.
AU - Marone, E. M.
AU - Bertoglio, L.
AU - Kahlberg, A.
AU - Carlucci, M.
AU - Chiesa, R.
PY - 2012/6
Y1 - 2012/6
N2 - Introduction: Recognition of acute mesenteric ischaemia (AMesI) in patients with aortic dissection (AoD) may be a challenge and exploratory laparotomy is often performed. Methods: We retrospectively analysed our experience with the use of diagnostic laparoscopy (DL) for the early detection of AMesI in patients with AoD, either undergoing medical treatment or after open/endovascular interventions. Results: Between 2004 and 2011, 202 consecutive AoDs were treated in our centre (71 acute type A AoD; 131 acute and chronic type B AoD). Among the 17 (8.4%) patients in which AMesI was suspected, nine (52.9%) were selected for DL. Three DLs were performed during medical treatment of patients with acute type B AoD, six after treatment of AoD (both surgical and endovascular). Three second-look DLs were also performed. Eight DLs were negative, three showed AMesI and the patients underwent successful emergent revascularisation. One DL was not conclusive and laparotomy was required. Among the eight patients not submitted to DL, one case of bowel infarction was recorded. Conclusions: In our series DL was feasible and safe. The low invasiveness and repeatability were the main advantages. Although additional experience is mandatory, DL seems a promising technique for the detection of AMesI in patients with AoD.
AB - Introduction: Recognition of acute mesenteric ischaemia (AMesI) in patients with aortic dissection (AoD) may be a challenge and exploratory laparotomy is often performed. Methods: We retrospectively analysed our experience with the use of diagnostic laparoscopy (DL) for the early detection of AMesI in patients with AoD, either undergoing medical treatment or after open/endovascular interventions. Results: Between 2004 and 2011, 202 consecutive AoDs were treated in our centre (71 acute type A AoD; 131 acute and chronic type B AoD). Among the 17 (8.4%) patients in which AMesI was suspected, nine (52.9%) were selected for DL. Three DLs were performed during medical treatment of patients with acute type B AoD, six after treatment of AoD (both surgical and endovascular). Three second-look DLs were also performed. Eight DLs were negative, three showed AMesI and the patients underwent successful emergent revascularisation. One DL was not conclusive and laparotomy was required. Among the eight patients not submitted to DL, one case of bowel infarction was recorded. Conclusions: In our series DL was feasible and safe. The low invasiveness and repeatability were the main advantages. Although additional experience is mandatory, DL seems a promising technique for the detection of AMesI in patients with AoD.
KW - Acute mesenteric ischaemia
KW - Aortic dissection
KW - Diagnosis
KW - Laparoscopy
UR - http://www.scopus.com/inward/record.url?scp=84861185277&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84861185277&partnerID=8YFLogxK
U2 - 10.1016/j.ejvs.2012.03.017
DO - 10.1016/j.ejvs.2012.03.017
M3 - Article
VL - 43
SP - 690
EP - 697
JO - European Journal of Vascular and Endovascular Surgery
JF - European Journal of Vascular and Endovascular Surgery
SN - 1078-5884
IS - 6
ER -