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Graft-related Complications (graft-related + complications)
Selected AbstractsSacrocolpopexy using xenogenic acellular collagen in patients at increased risk for graft-related complications,,NEUROUROLOGY AND URODYNAMICS, Issue 4 2010Filip Claerhout Abstract Aims We studied the long-term anatomical and functional outcome following sacrocolpopexy for apical vaginal prolapse using xenogenic grafts in a population at increased risk for graft-related complications (GRCs). Methods Twenty-two consecutive patients with symptomatic apical prolapse were scheduled for laparoscopic sacrocolpopexy (LSC) with porcine grafts because they were presumed to be at risk for GRC, because of pre-existing vaginal ulcerations (n,=,4), concomitant vaginal prolapse repair (n,=,15), total hysterectomy (n,=,1), or intra-operative abdominal contamination due to accidental laceration of the vagina, bowel perforation (n,=,1) or the presence of infection (n,=,1). Either small intestinal submucosa (n,=,8) or dermal collagen (n,=,14) was used. Outcome measures were GRCs, anatomical cure (,Stage I at any compartment), subjective cure, impact on bowel, bladder, and sexual function measured by a standardized interview. Results At study closure 20 (91%) patients were available for functional evaluation and 16 (73%) for anatomical evaluation at a mean follow-up period of 27.4 months. The GRC rate was 25% (n,=,4) prompting reintervention in half, and including two patients with spondylodiscitis. The anatomical cure rate was 31.5%. Failures at the vault, anterior, and posterior compartments occurred in, respectively, 31%, 18.8%, and 50% of patients. The subjective cure rate was 60% and three patients (15%) underwent redo-LSC. Conclusion The strategy of using xenografts in patients at risk for GRC, did not prevent these to occur and was associated with a high anatomical and functional failure rate as well as reoperation rate. Neurourol. Urodynam. 29:563,567, 2010. © 2009 Wiley-Liss, Inc. [source] Use of baseline factors to predict complications and reinterventions after endovascular repair of abdominal aortic aneurysm,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2010L. C. Brown Background: It is uncertain which baseline factors are associated with graft-related complications and reinterventions after endovascular aneurysm repair (EVAR) in patients with a large abdominal aortic aneurysm. Methods: Patients randomized to elective EVAR in EVAR Trial 1 or 2 were followed for serious graft-related complications (type 2 endoleaks excluded) and reinterventions. Cox regression analysis was used to investigate whether any prespecified baseline factors were associated with time to first serious complication or reintervention. Results: A total of 756 patients who had elective EVAR were followed for a mean of 3·7 years, by which time there were 179 serious graft complications (rate 6·5 per 100 person years) and 114 reinterventions (rate 3·8 per 100 person years). The highest rate was during the first 6 months, with an apparent increase again after 2 years. Multivariable analysis indicated that graft-related complications increased significantly with larger initial aneurysm diameter (P < 0·001) and older age (P = 0·040). There was also evidence that patients with larger common iliac diameters experienced higher complication rates (P = 0·011). Conclusion: Graft-related complication and reintervention rates were common after EVAR in patients with a large aneurysm. Younger patients and those with aneurysms closer to the 5·5-cm threshold for intervention experienced lower rates. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] | ||||||||||