Ishibashi Hiroyuki, Ohta Takashi, Sugimoto Ikuo, Iwata Hirohide, Kawanishi Jun, Yamada Tetsuya, Tadakoshi Masao, Hida Noriyuki
Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan.
Surg Today. 2008;38(11):1004-8. doi: 10.1007/s00595-007-3755-6. Epub 2008 Oct 29.
To define the indications for abdominal aortic aneurysm (AAA) surgery in octogenarians.
We reviewed septuagenarians and octogenarians with a nonspecific AAA diagnosed at our hospital between January, 1990 and June, 2006.
Among a total 628 patients seen, 306 were in their 70s (group A) and 108 were in their 80s or older (group B). The mortality rate associated with elective surgery was 1.9% in group A and 7.0% in group B. Of the survivors, 12 (5.7%) of 210 in group A and 8 (15.1%) of 53 in group B died within 2 years. Of the patients who did not undergo surgery, 8 of 53 in group A and 8 of 31 in group B had AAAs greater than 6 cm in diameter. The rupture-free rates of AAAs greater than 6 cm in diameter were 64% at 1 year and 0% at 4 years in group A, and 88% at 1 year and 26% at 3 years in group B. The rupture-free rates of AAAs smaller than 6 cm in diameter were 95% at 3 years and 85% at 5 years in group A, and 100% at 5 years in group B.
We concluded that AAAs over 6 cm in diameter were an appropriate indication for surgery in octogenarians.
明确八旬老人腹主动脉瘤（AAA）手术的适应证。
我们回顾了1990年1月至2006年6月期间在我院诊断为非特异性AAA的七旬和八旬老人。
在总共628例患者中，306例为70多岁（A组），108例为80多岁及以上（B组）。A组择期手术的死亡率为1.9%，B组为7.0%。在幸存者中，A组210例中有12例（5.7%），B组53例中有8例（15.1%）在2年内死亡。在未接受手术的患者中，A组53例中有8例，B组31例中有8例的腹主动脉瘤直径大于6 cm。A组直径大于6 cm的腹主动脉瘤1年时无破裂率为64%，4年时为0%；B组1年时为88%，3年时为26%。A组直径小于6 cm的腹主动脉瘤3年时无破裂率为95%，5年时为85%；B组5年时为100%。
我们得出结论，直径超过6 cm的腹主动脉瘤是八旬老人手术的合适适应证。
