Evidence map›Paper›PMID 33602217›Full record

ArticleBMC surgery2021

Interdisciplinary approach in emergency revascularization and treatment for acute mesenteric ischemia.

Alicja Zientara, Anja-Rebeka Domenghino, Igor Schwegler, Hans Bruijnen, Annelies Schnider, Markus Weber, Stefan Gutknecht, Nicolas Attigah

Abstract read
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In one paragraph

Article in BMC surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alicja ZientaraDepartment of Cardiothoracic Surgery, Royal Brompton and Harefield Hospital, Harefield, UK.
Anja-Rebeka DomenghinoDepartment of Vascular Surgery, Triemli Hospital, 497, 8063, Zurich, Switzerland.
Igor SchweglerDepartment of Vascular Surgery, Triemli Hospital, 497, 8063, Zurich, Switzerland.
Hans BruijnenAugsburg City Hospital, Augsburg, Germany.
Annelies SchniderDepartment of Visceral Surgery, Triemli Hospital, Zürich, Switzerland.
Markus WeberDepartment of Visceral Surgery, Triemli Hospital, Zürich, Switzerland.
Stefan GutknechtDepartment of Visceral Surgery, Triemli Hospital, Zürich, Switzerland.
Nicolas AttigahDepartment of Vascular Surgery, Triemli Hospital, 497, 8063, Zurich, Switzerland. nicolas.attigah@triemli.zuerich.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMesenteric ischemia is associated with poor outcome and high overall mortality. The aim was to analyze an interdisciplinary treatment approach of vascular and visceral specialists focusing on the in-hospital outcome and follow-up in patients with acute and acute-on-chronic mesenteric ischemia.

methodsFrom 2010 until 2017, 26 consecutive patients with acute or acute on chronic mesenteric ischemia were treated by an interdisciplinary team. Data were prospectively collected and retrospectively evaluated. Throughout the initial examination, the extent of bowel resection was determined by the visceral surgeon and the appropriate mode of revascularization by the vascular surgeon. The routine follow-up included clinical examination and ultrasound- or CT-imaging for patency assessment and overall survival as primary endpoint of the study.

resultsOut of 26 patients, 18 (69.2%) were rendered for open repair. Ten patients (38.5%) received reconstruction of the superior mesenteric artery with an iliac-mesenteric bypass. Seven patients (26.9%) underwent thrombembolectomy of the mesenteric artery. One patient received an infra-diaphragmatic aorto-celiac-mesenteric bypass. Out of the 8 patients, who were not suitable for open revascularization, 2 patients (7.7%) were treated endovascularly and 6 (23.1%) underwent explorative laparotomy. The in-hospital mortality was 23% (n = 6). The mean survival of the revascularized group (n = 20) was 51.8 months (95% CI 39.1-64.5) compared to 15.7 months in the non-revascularized group (n = 6) (95% CI - 4.8-36.1; p = 0.08). The median follow-up was 64.6 months. Primary patency in the 16 patients after open and 2 after interventional revascularization was 100% and 89.9% in the follow-up.

conclusionThe interdisciplinary treatment of mesenteric ischemia improves survival if carried out in time. Hereby open revascularization measures are advantageous as they allow bowel assessment, resection, and revascularization in a one-stop fashion especially in advanced cases.

Indexed as

Emergency Medical ServicesMesenteric IschemiaPatient Care TeamAcute DiseaseHumansMesenteric Artery, SuperiorRetrospective StudiesTreatment OutcomeVascular Surgical ProceduresAcute mesenteric ischemiaBowel resectionIliac-mesenteric bypassIntestinal ischemiaMesenteric revascularizationThrombembolectomy of superior mesenteric artery

Identifiers

PMID33602217
PMCPMC7890998

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.