Impact of left renal vein division during abdominal aortic aneurysm surgery on immediate and long-term renal function
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Date
2019-12
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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.