AB199. SOH25_AB_295. The impact of left renal vein ligation on renal function in open abdominal aortic surgery—a systematic review and meta-analysis

Background: Left renal vein (LRV) ligation aortic surgery leads to better exposure of the aortic neck. However, it is believed to have sequelae such as postoperative renal dysfunction. This systematic review and meta-analysis aims to report the impact of LRV ligation on renal function in open abdominal aortic surgery (OAAS).

Methods: Studies included LRV ligation versus LRV preservation in patients who underwent OAAS that reported the incidence of acute kidney injury (AKI), perioperative serum estimated glomerular filtration rate (eGFR), or serum creatinine (SCr) levels. The primary outcome was the incidence of postoperative AKI. The secondary outcomes were postoperative eGFR and SCr from postoperative day 1 to follow-up.

Results: Eight studies (1,242 patients with LRV preserved and 353 patients with LRV ligated) were included. Ligation of the LRV was associated with a higher incidence of postoperative AKI (odds ratio 2.78, P=0.002). Ligation of the LRV was associated with significantly lower eGFR levels on postoperative day 1 (P=0.01) and postoperative day 7 (P=0.01), but no difference on follow-up (P=0.07). In patients with LRV ligation, postoperative SCr levels were significantly higher on postoperative day 1 (P=0.02) but were similar on follow-up (P=0.22).

Conclusions: Ligation of the LRV during OAAS seemed to increase the risk of AKI in the early postoperative phase. However, on follow-up, this risk is mitigated, and there does not seem to be long-term renal sequelae.

Keywords: Renal vein ligation; abdominal aortic aneurysm repair; acute renal injury; estimated glomerular filtration rate (eGFR); serum creatinine (SCr)