Comparison of perioperative factors of elective abdominal aortic aneurysm surgery and those of ruptured abdominal aortic aneurysm surgery

摘要

BACKGROUND: Currently the mortality rate of elective abdominal aortic aneurysm (eAAA) surgery has improved. However the mortality rate of ruptured abdominal aortic aneurysm (rAAA) surgery remains high. We compared perioperative variables of eAAA surgery and those of rAAA surgery. METHODS: From 1997 to 2002, 98 consecutive patients who had undergone graft replacement of infrarenal AAA (56 eAAA and 42 rAAA) were evaluated retrospectively. RESULTS: Significant differences existed between eAAA and rAAAs in following perioperative variables: agg (eAAA: 74.2 +/- 6.8 years, rAAA: 74.2 +/- 8.6 years), duration from the admission to the time of starting operation (eAAA: 62 +/- 11 min, rAAA: 28 +/- 17 min), duration from the time of starting operation to the aortic cross clamping (eAAA: 87 +/- 29 min, rAAA: 29 +/- 32 min), duration of the aortic cross clamping (eAAA:59 +/- 19 min, rAAA: 71 +/- 29 min), blood loss (eAAA: 1297 +/- 1046 ml, rAAA: 4619 +/- 4960 ml), total amount of blood products required (eAAA: 1058 +/- 953 ml, rAAA: 5619 +/- 4945 ml), intensive and/or high care unit stay (eAAA: 1.8 +/- 1.2 days, rAAA: 6.4 +/- 8.1 days), the postoperative mortality rate (eAAA: 0%, rAAA: 19%), and postoperative complications (eAAA: 14%, rAAA: 48%), CONCLUSIONS: Patients who had undergone rAAA surgery had higher mortality and more postoperative complications than those after eAAA surgery. Elective rapair before AAA ruptures is recommended.