ABSTRACT
Anastomotic leak is a serious complication of colonic surgery. The aim of our study is to evaluate the impact of vascular calcifications of the celiac axis and superior mesenteric artery in patients undergoing elective right colectomy, and particularly their relationship to the risk of anastomotic leak. MATERIALS AND METHODS: We performed a retrospective analysis of preoperative abdominal computerized tomography (CT) scans of patients who underwent right colectomy at the Vendean Departmental Hospital (France) between January 2011 and December 2016. We established a calcification score, which was correlated to the incidence of anastomotic leak and to the patients' American Society of Anesthesiologists (ASA) score. RESULTS: The charts of 250 patients were reviewed. Twenty-three patients had a postoperative anastomotic leak. A stratified analysis revealed that the risk of developing an anastomotic leak was statistically significantly increased in patients whose calcification score was equal to or greater than 3 (P<0.05). In these patients, the risk was increased by a factor of 3.48 [odds ratio: 3.48 (1.45-8.36)]. A second stratified analysis showed that a calcification score of 2 at the level of the celiac axis takeoff was correlated with a statistically significantly increased risk of anastomotic leak (P<0.01). There was a correlation between a calcification score≥3 and an ASA score≥3. CONCLUSION: A calcification score≥3 correlates to an increased risk of anastomotic leak. The analysis of CT findings is simple, easy and reproducible. This calcification score should be confirmed by a prospective study.
Subject(s)
Anastomotic Leak/diagnosis , Celiac Artery/diagnostic imaging , Colectomy/adverse effects , Mesenteric Artery, Superior/diagnostic imaging , Tomography, X-Ray Computed/methods , Vascular Calcification/diagnosis , Adult , Aged , Aged, 80 and over , Anastomotic Leak/epidemiology , Anastomotic Leak/etiology , Elective Surgical Procedures/adverse effects , Female , France/epidemiology , Humans , Incidence , Male , Middle Aged , Predictive Value of Tests , Prospective Studies , Retrospective Studies , Risk Factors , Vascular Calcification/complications , Young AdultABSTRACT
Atherosclerotic common femoral artery (CFA) disease is a well-known and frequent cause of symptomatic peripheral artery disease (PAD). Not so long ago, surgical treatment was considered the gold standard and the main treatment option. Therapeutic advances have, however, provided a wide and suitable armamentarium. These advances concern medical treatment and the direct treatment of lesions by open surgery or endovascular treatment. The aim of this manuscript was to summarize therapeutic updates and to describe the current endovascular and open surgical procedures used to treat common femoral artery disease.
