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[Perioperative outcomes after endovascular versus open repair of abdominal aortic aneurysms: a single center experience]. 2012
OBJECTIVE To evaluate the outcomes of endovascular repair (EVAR) versus open repair (OR) in the patients with abdominal aortic aneurysm (AAA) and compare their perioperative rates of morbidity and mortality. METHODS The clinical data of 371 AAA patients from January 2006 to January 2011 were collected and analyzed. Endovascular (n = 174) and open (n = 197) repairs were performed. The relevant parameters included preoperative status, intraoperative blood loss, procedure time, intensive care unit (ICU) stay length, ventilatory support time, postoperative fasting time and duration of postoperative hospital stay and anesthesia methods. The perioperative rates of morbidity and mortality were presented. RESULTS The patients of EVAR group were elder than those of OR group [(72 ± 8) vs (60 ± 14) years old, P = 0.000]. The comorbidity rate of chronic obstructive pulmonary disease (COPD) in EVAR group was higher than that in OR group (31.0% vs 21.8%, P = 0.045). As compared with OR group, the EVAR group had less blood loss [(125 ± 43) vs (858 ± 602) ml, P = 0.000], a lower rate of blood transfusion (0 vs 71.1%, P = 0.000), shorter ICU stay length [(15 ± 5) vs (31 ± 11) h, P = 0.000], shorter postoperative fasting time [(7 ± 4) vs (90 ± 32) h, P = 0.000], shorter procedure time [(146 ± 39) vs (210 ± 24) min, P = 0.000] and shorter ventilatory support time [(90 ± 23) vs (220.0 ± 132.0) min, P = 0.000]. In EVAR group, general (88, 50.6%), epidural (52, 30.0%) and local (34, 19.4%) anesthesia were used. General anesthesia was used for all OR group patients. The duration of postoperative hospital stay was similar in two groups (9.1 ± 2.7) d vs (9.2 ± 2.6) d (P = 0.798). The perioperative complication rate was lower in EVAR group (12.6% vs 27.0%, P = 0.001). And the 30-day mortality rate was 1.15% in EVAR group and 2.0% in OR group. CONCLUSIONS Endovascular repair is less-invasive in AAA patients and offers significant advantages over open surgery. Especially it is indicated for those patients non-suitable for open surgery. And a long-term survival rate is expected.
