Ballard Jeffrey L, Abou-Zamzam Ahmed M, Teruya Theodore H, Bianchi Christian, Petersen Floyd F
Division of Vascular Surgery, Loma Linda University Medical Center, CA 92354-3227, USA.
J Vasc Surg. 2004 Apr;39(4):797-803. doi: 10.1016/j.jvs.2003.11.037.
This study was undertaken to evaluate changes in quality of life and to compare conventional outcomes in patients undergoing endovascular and open retroperitoneal abdominal aortic aneurysm (AAA) repair.
Between October 2000 and May 2003, 129 patients underwent elective AAA repair, endovascular repair in 22 patients and open retroperitoneal repair in 107 patients. The Short-Form Health Survey, 12 items (SF-12) was administered preoperatively and at 3 weeks, 4 months, and 1 year after discharge. Quality of life, hospital and intensive care unit stay, perioperative complications, discharge disposition, readmission, and hospital cost were statistically evaluated.
For the total group, significant differences were observed for both Physical Component Summary scores (P<.001) and Mental Component Summary scores (P=.001) between time points. There were no significant differences for either Component Summary score between open and endovascular procedures for any time period. Number of weeks required to return to baseline functional status was similar after either open or endovascular repair (7.22 vs 5.47 weeks, respectively; P=.09). Mean hospital and intensive care unit stay was 4.4 and 1 days, respectively, for open repair versus 1.9 and 0 days, respectively, for endovascular repair (P<.0001). No significant difference between groups was observed in terms of perioperative complications, discharge disposition, or hospital readmission (P> or =.54). Mean total hospital cost for endovascular repair was 1.60 times that for open repair (mean difference, $11,662; P<.0001; 95% confidence interval, $17,799-$5525).
Hospital stay is significantly shorter after endovascular AAA repair. However, hospital cost is almost twice that for open retroperitoneal repair. Perioperative complications, discharge disposition, and hospital readmission are not statistically different between the two groups. Effect on health-related quality of life is similar after either open retroperitoneal or endovascular AAA repair.
本研究旨在评估腹主动脉瘤（AAA）患者接受血管内修复和开放性腹膜后修复术后生活质量的变化，并比较传统疗效指标。
2000年10月至2003年5月期间，129例患者接受了择期AAA修复术，其中22例行血管内修复，107例行开放性腹膜后修复。术前及出院后3周、4个月和1年进行12项简短健康调查问卷（SF - 12）评估。对生活质量、住院时间、重症监护病房停留时间、围手术期并发症、出院情况、再入院情况及住院费用进行统计学评估。
对于整个研究组，各时间点之间的身体成分汇总得分（P <.001）和心理成分汇总得分（P =.001）均存在显著差异。在任何时间段，开放性手术和血管内手术之间的成分汇总得分均无显著差异。开放性修复和血管内修复后恢复至基线功能状态所需的周数相似（分别为7.22周和5.47周；P =.09）。开放性修复的平均住院时间和重症监护病房停留时间分别为4.4天和1天，而血管内修复分别为1.9天和0天（P <.0001）。两组在围手术期并发症、出院情况或再入院方面无显著差异（P≥.54）。血管内修复的平均总住院费用是开放性修复的1.60倍（平均差值为11,662美元；P <.0001；95%置信区间为17,799 - 5525美元）。
血管内AAA修复术后住院时间显著缩短。然而，住院费用几乎是开放性腹膜后修复的两倍。两组在围手术期并发症、出院情况和再入院方面无统计学差异。开放性腹膜后或血管内AAA修复对健康相关生活质量的影响相似。
