The evaluation of the postoperative course in patients operated due to abdominal aortic aneurysm as urgent or elective procedure
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Introduction: The patients with the aortic abdominal aneurysym of 55 mm in diameter are qualified to surgery. There are open repair (OR) by means of the vascular prosthesis implantation or the less invassive endovascular method by means of the stentgraft implantation through femoral arteries incision (EndovascularAorticRepair – EVAR). Aim: The aim of the study was the evaluation of the postoperative course in patients operated due to aortic abdominal aneurysm and the evaluation of the impact of the surgical method on the short-time results. Material and methods: 124 patients operated due to abdominal aortic aneurysm in Dept of Surgery of 4th Military Hospital in Wroclaw in 2014 were enrolled into the study: 53 patients with OR, 53 patients with EVAR, and 19 patients with ruptured aneurysm. Results: Mortality was 0% in EVAR and 6% in OR and 39% in ruptured aneurysm. Time of hospital stay was 5.8 days in EVAR vs 10 days in OR. The stay in ICU was 0% in EVAR vs 13% in OR. Blood transfusion was 9.4% in EVAR vs 66% in OR. Time of postoperative analgesia was 27 h in EVAR vs 76.8 h in OR. Cardio-respiratory decompensation was 1.9% in EVAR vs 7.6% in OR. Renal insufficiency was 2% in EVAR vs 9% in OR. The lower rate of organ complications was in EVAR. The ruptured aneurysm presented the most complicated postoperative course: hospital stay of 11.4 days, ICU stay of 78%, blood transfusion of 100%, painkillers of 136 hours, cardio-respiratory decompensation of 81% and renal insufficiency of 69%. Conclusions: The method of treatment, the conditions of the admision and the type of surgery influenced the postoperative course. The elective EVAR patients presented both the 0% of mortality and the lightest postoperative course. The ruptured abdominal aortic aneurysms operated as an emergency had the most complicated postoperative course.
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