Postoperative renal function after an abdominal aortic aneurysm repair requiring a suprarenal aortic cross-clamp.
We describe herein the postoperative renal functions of patients who required a suprarenal aortic cross-clamp during abdominal aortic surgery. Seven patients required a unilateral suprarenal aortic cross-clamp (group A) and six patients required a bilateral suprarenal clamp (group B). Eighty-three patients who required an infrarenal aortic clamp were assigned to group C. Renal hypothermia with renal perfusion or topical cooling during suprarenal clamp was not performed. No hospital deaths were encountered. In group B, the postoperative creatinine and blood urea nitrogen (BUN) levels remained statistically significantly higher than that of group C until the seventh postoperative day. The postoperative renal dysfunction (serum creatinine level >2.0 mg/dl) was 28.6% in group A and 50% in group B, while it was only 8.4% in group C, although no patient required either temporary or permanent hemodialysis. The postoperative peak BUN over 30 min suprarenal clamp was significantly higher than that within 30 min. In summary, the postoperative renal function was impaired after an extended bilateral suprarenal clamp. These findings suggest that if prolonged renal ischemia is thus expected, then renal preservation should be considered.
Sasaki
T
T
Third Department of Surgery, Iwate Medical University, Morioka, Japan.
Ohsawa
S
S
Ogawa
M
M
Mukaida
M
M
Nakajima
T
T
Komoda
K
K
Tachieda
R
R
Niinuma
H
H
Kawazoe
K
K
D000368:Aged; D001012:Aorta, Abdominal; D017544:Aortic Aneurysm, Abdominal / Q000503:physiopathology / Q000601:surgery*; D016022:Case-Control Studies; D003250:Constriction; D005260:Female; D006801:Humans; D007511:Ischemia / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply / Q000503:physiopathology*; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology*; D011184:Postoperative Period; D013997:Time Factors