Zhang Chang-Lie, Song Zhi-Hong, Wang Fan
Department of Vascular Surgery, Linyi People's Hospital Affiliated to Shandong University, Linyi, China.
Am J Ther. 2016 Jan-Feb;23(1):e37-43. doi: 10.1097/MJT.0000000000000289.
To explore the efficacy of endovascular aneurysm repair (EVAR) compared with traditional open surgical repair (OSR) in the treatment of middle/high-risk patients with abdominal aortic aneurysm (AAA). With a retrospective method, we analyzed the clinical data of 57 patients with middle/high-risk AAA admitted to Linyi People's Hospital Affiliated to Shandong University from January 2010 to January 2014. Twenty-eight of the 57 patients received EVAR and 29 others received OSR. Statistical analysis was conducted by the design of spreadsheet according to preoperative, intraoperative, perioperative, and postoperative follow-up relevant information. Our study showed that the difference in baseline characteristics of different therapies in middle/high-risk AAA patients was not statistically significant in preoperative period (P > 0.05). In intraoperative period, the efficacy of middle/high-risk AAA patients in EVAR group was significantly superior to OSR group in terms of blood loss, blood transfusion, and general anesthesia rate (all P < 0.01). In perioperative period, the ICU observation time and the average fasting time of middle/high-risk AAA patients in EVAR group were remarkably lower than OSR group (all P < 0.01), but the average hospital stay and the operation cost of middle/high-risk AAA patients in EVAR group were notably higher than OSR group. In postoperative follow-up period, OSR group was identified with a lower incidence of surgery-related complications than EVAR group (P < 0.05), but EVAR group was demonstrated with a higher survival rate than OSR group (P < 0.05); after 12 months of follow-up, SF-36 scale scores in OSR group were higher than EVAR group (P < 0.05). In conclusion, EVAR may have a better short-term effect, whereas OSR may have a better long-term effect in the treatment of middle/high-risk AAA patients.
探讨血管内动脉瘤修复术(EVAR)与传统开放手术修复术(OSR)治疗中/高危腹主动脉瘤(AAA)患者的疗效。采用回顾性方法,分析了2010年1月至2014年1月山东大学附属临沂市人民医院收治的57例中/高危AAA患者的临床资料。57例患者中,28例行EVAR治疗,29例行OSR治疗。根据术前、术中、围手术期及术后随访的相关信息,通过电子表格设计进行统计分析。研究表明,中/高危AAA患者不同治疗方法的基线特征在术前差异无统计学意义(P>0.05)。术中,EVAR组中/高危AAA患者在失血、输血及全身麻醉率方面的疗效显著优于OSR组(均P<0.01)。围手术期,EVAR组中/高危AAA患者的ICU观察时间和平均禁食时间显著低于OSR组(均P<0.01),但EVAR组中/高危AAA患者的平均住院时间和手术费用显著高于OSR组。术后随访期,OSR组手术相关并发症的发生率低于EVAR组(P<0.05),但EVAR组的生存率高于OSR组(P<0.05);随访12个月后,OSR组的SF-36量表评分高于EVAR组(P<0.05)。综上所述,在治疗中/高危AAA患者时,EVAR可能具有更好的短期效果,而OSR可能具有更好的长期效果。