title: In-situ revascularisation for secondary aorto-enteric fistulae: the success of silver-coated Dacron is closely linked to a suitable bowel repair.
abstract: OBJECTIVE
  The purpose of this study was to assess short- and mid-term results of in-situ revascularisation (ISR) using silver-coated Dacron prostheses and bowel repair for management of secondary aorto-enteric fistulae (SAEF).
  
  
  METHODS
  Single-centre retrospective chart review.
  
  
  METHODS
  This study includes all the patients treated by ISR using silver-coated Dacron for SAEF between 2006 and 2010. Primary end points were mortality and survival rates. Secondary end points were reinfection-free survival and secondary patency rates.
  
  
  RESULTS
  Eighteen male patients with SAEF with a median age of 64 years were operated by ISR using silver-coated Dacron during the study period without operative death. The 30-day mortality was 22% and the in-hospital mortality rate was 39%. Indeed, during hospitalisation, a duodenal leak was observed in four patients including three who died. Four others patients died due to multi-system organ failure. Median follow-up was 16 months (range 1-66). The survival rate at 12 months was 55%. One duodenal leak was observed leading to death. The reinfection-free survival and the secondary patency rates at 12 months were 60% and 89%, respectively.
  
  
  CONCLUSIONS
  In-situ revascularisation with silver-coated Dacron provides acceptable results in terms of mortality. This treatment may be useful for simple vascular reconstruction and allow greater attention to bowel repair that is a determinant in short- and mid-term survival.
authors.affiliation: Department of Vascular Surgery, University Hospital of Bordeaux, Tripode-Pellegrin, Place Amelie Raba Leon, 33000 Bordeaux, France.
authors.forename: J C
authors.initials: JC
authors.lastname: Delva
authors.forename: S
authors.initials: S
authors.lastname: Déglise
authors.forename: X
authors.initials: X
authors.lastname: Bérard
authors.forename: V
authors.initials: V
authors.lastname: Dubuisson
authors.forename: F
authors.initials: F
authors.lastname: Delva
authors.forename: L
authors.initials: L
authors.lastname: Stecken
authors.forename: E
authors.initials: E
authors.lastname: Ducasse
authors.forename: D
authors.initials: D
authors.lastname: Midy
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D001012:Aorta, Abdominal / Q000601:surgery; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D020099:Coated Materials, Biocompatible; D004378:Duodenal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D004386:Duodenum / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011474:Prosthesis Design; D012189:Retrospective Studies; D012834:Silver; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D020099:Coated Materials, Biocompatible; D011093:Polyethylene Terephthalates; D012834:Silver