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80 岁以上患者行腹主动脉瘤修复后可达到正常预期寿命:血管内修复与开放手术的比较。

Patients Older Than 80 Years Can Reach Their Normal Life Expectancy After Abdominal Aortic Aneurysm Repair: A Comparison Between Endovascular Aneurysm Repair and Open Surgery.

机构信息

1 Department of Vascular and Endovascular Surgery, University Hospital of Cologne, Germany.

出版信息

J Endovasc Ther. 2018 Apr;25(2):247-251. doi: 10.1177/1526602818759757. Epub 2018 Feb 21.

Abstract

PURPOSE

To investigate the long-term outcomes of endovascular aneurysm repair (EVAR) and open surgical repair (OSR) of infrarenal abdominal aortic aneurysm in octogenarian patients and to compare them with the overall expected survival based on a sex- and age-matched German population.

METHODS

A total of 177 patients (median age 82 years; 149 men) ≥80 years old (range 80-92) who underwent primary elective repair of an infrarenal aortic aneurysm (≥5 cm) between 1998 and 2015 were identified in a database search. Two groups of patients were formed based on the type of procedure: 131 EVAR patients (median age 83 years; 114 men) and 46 OSR patients (median age 82 years; 35 men).

RESULTS

The median follow-up was 5 years for the OSR group and 4.5 years for the EVAR group. Kaplan-Meier analysis showed no significant difference in survival between the EVAR and OSR groups at 78 months. The observed survival of all study patients was not statistically different from the expected survival of a sex- and age-matched German population, which was true separately for women and men.

CONCLUSION

The patients in this study seemed to reach normal life expectancy in comparison to the age- and sex-matched general population with a similar cumulative survival in both study groups over 5 years of follow-up.

摘要

目的

研究 80 岁以上老年患者腹主动脉瘤腔内修复术(EVAR)和开放手术修复(OSR)的长期疗效,并与基于性别和年龄匹配的德国人群的总体预期生存进行比较。

方法

在数据库检索中确定了 1998 年至 2015 年间接受择期治疗的 177 名(中位年龄 82 岁;149 名男性)≥80 岁(80-92 岁)的腹主动脉瘤(≥5 cm)的老年患者。根据手术类型将两组患者分为:131 名 EVAR 患者(中位年龄 83 岁;114 名男性)和 46 名 OSR 患者(中位年龄 82 岁;35 名男性)。

结果

OSR 组的中位随访时间为 5 年,EVAR 组为 4.5 年。Kaplan-Meier 分析显示,78 个月时 EVAR 组和 OSR 组的生存无显著差异。所有研究患者的观察生存率与性别和年龄匹配的德国人群的预期生存率无统计学差异,女性和男性均如此。

结论

与年龄和性别匹配的一般人群相比,该研究中的患者似乎达到了正常的预期寿命,两组患者在 5 年的随访中累积生存率相似。

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