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Master Thesis

Intérêt du conditionnement ischémique préopératoire par embolisation artérielle avant œsophagectomie : étude rétrospective contrôlée sur 26 patients pris en charge au CHU de Grenoble

Abstract : Objectives : To study feasibility and outcome of ischemic conditioning by arterial embolization before esophagectomy. Methods: Retrospective study of 26 consecutive patients, comparing a postoperative group of 12 patients conditioned with a control group of 14 patients from 2008 to 2011. Outcome measures are anastomotic leaks, success and complications of embolization, and postoperative complications. Results: Preoperative arterial embolization provides a non-significant decrease in overall anastomotic morbidity from 42.9% to 16.7% (Odds Ratio = 3.75, p = 0.216). It mainly concerns anastomotic leaks (OR = 8.25, p = 0.081) and severe anastomotic complications (OR not calculable, p = 0.100). Primary success of embolization was 76.9%, the failures being all attributable to the right gastric artery. No serious complication occurred. The change in postoperative creatinine was slightly higher after conditioning with an average of +1,9% compared to -15.8% (p = 0.028), maybe due to the exclusion of died patients of this calculation. Conclusion: Ischemic conditioning by arterial embolization improves gastric tube vascularization, and seems effective in order to decrease anastomotic morbidity, which is heavily involved in postoperative mortality. It is necessary to accurately assess kidney function to prevent its degradation.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00633341
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Submitted on : Tuesday, October 18, 2011 - 12:14:08 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:16 AM
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Sébastien Guigard. Intérêt du conditionnement ischémique préopératoire par embolisation artérielle avant œsophagectomie : étude rétrospective contrôlée sur 26 patients pris en charge au CHU de Grenoble. Médecine humaine et pathologie. 2011. ⟨dumas-00633341⟩

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