USE OF ARTIFICIAL CIRCULATION DURING PROSTHETIC REPAIR OF THE ABDOMINAL AORTA IN SINGLE-STEP OPERATIONS (A META-ANALYSIS)

Belov Yu. V., Bazylev V.V., Savichev D.D.
Department of Surgery of the Aorta and Its Branches, Federal Facility Russian Scientific Centre of Surgery named after Academician B.V. Petrovsky, Russian Academy of Medical Sciences,
Moscow, Russia

To assess the risk of complications during the use of extracorporeal circulation at the stage of prosthetic reconstruction of the abdominal aorta in single-step interventions we carried out a systemic analysis of 20 publications mentioning the use of artificial circulation during aortic reconstruction, as well as analysed the works wherein aortic prosthetic repair was performed after artificial circulation was discontinued. The postoperative mortality rate in single-step interventions with the use of artificial circulation at the stage of aortic prosthetic reconstructions ranges from 0 to 25%, and that without artificial circulation varies from 0-6.7%. A meta-analysis of the publications showed that the cumulative relative risk for development of complications is 3.14 times greater in those patients who at the stage of aortic reconstruction continued receiving artificial circulation. The use of artificial circulation does not decrease the incidence rate of myocardial infarction neither does it influence the rate of development of haemorrhage or purulent complications. However, the use of artificial circulation at the stage of prosthetic reconstruction of the abdominal aorta considerably increases the incidence rate of respiratory, renal and neurological complications. Hence, the advantages of using artificial circulation are levelled by high incidence of complications, while the opinion that the use of artificial circulation at the stage of prosthetic repair of the abdominal aorta decreases the incidence of myocardial infarction was not confirmed in our systemic review, therefore the use of extracorporeal circulation in single-step operations should be well-grounded.

KEY WORDS: single-step operations, artificial circulation, aortic prosthetic reconstruction.

P. 111-115

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