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Title: Impact of left renal vein division during abdominal aortic aneurysm surgery on immediate and long-term renal function
Authors: Harishankar. R
Issue Date: Dec-2019
Publisher: SCTIMST
Abstract: Open surgical repair is the gold standard in the treatment of abdominal aortic aneurysms. The surgical technique has improved so vastly over the years, that even high risk patients can undergo the procedure with acceptable morbidity. Juxtarenal aortic aneurysms and the aneurysms with difficult or hostile neck anatomy like large aneurysm hindering clamp space or crossing of left renal vein (LRV) pose serious technical challenge to the operating surgeon. There are different techniques to tackle this and one such important method is division of left renal vein. Although described by many authors, there are contradicting reports in the literature regarding the safety of the same and need for routine reconstruction of vein. This study intends to look into the immediate post-operative and long term renal function of all patients who underwent left renal vein division during elective abdominal aortic aneurysm surgery. Left renal vein division was employed more commonly than other methods in juxtarenal aortic aneurysms and infrarenal aortic aneurysms with difficult neck anatomy. Renal function in the LRV division group was further analysed based on aortic clamp placement (suprarenal, inter-renal or infrarenal). Blood urea, serum creatinine and estimated glomerular filtration rate (eGFR) were measured preoperatively, in the post-operative period and during follow up.
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