| Background and Objective: Currently, EVAR has become the first-line treatment of AAA, the traditional open surgery repair in our hospital has been replaced by trends of EVAR. By comparing the open surgery repair group with the endovascular repair group on general surgery-related conditions, perioperative treatment and recovery, as well as the postoperative complications and hospital costs, we want to analysis the comprehensive evaluation of the efficacy of two surgical methods to find appropriate treatment.Material and methods: There are some of AAA patients who were diagnosed exactly from the preoperative application of CTA or MRA from Wuhan Union Hospital vascular surgery between January 2007 and December 2010. They were all experienced the surgical treatment: EVAR or OSR. Open surgery repair was under general anesthesia and the surgical method is abdominal aortic aneurysm resection and graft replacement, artificial blood vessels were made of PTFE. Endovascular repair was under local anesthesia using endovascular stents which were made of COOK Zenith. We performed a retrospective analysis of 48 consecutive patients with AAA in our department in January 2007～December 2010. The patients were divided into open repair in 17 patients named group A and endovascular repair in 31 patients named group B by the manner of operation. Compare the open surgery repair group with the endovascular repair group on general surgery-related conditions, perioperative treatment and recovery, as well as the postoperative complications and the survival condition.Results: General comparison between the two groups: there were 48 cases in all, 31 cases of male patients accounted for 64.58%, 17 cases of female patients accounted for 35.42%. The gender and the body mass index composition between group A and group B had no significant difference (P > 0.05). The average age of group A is (60.88±6.47) years old and group B is (71.84±11.67) years old, there was a significant difference between the two groups (P < 0.05), group A was less than group B in the age composition. Group A and group B had differences in aneurysm diameter (P < 0.05), in the average aneurysm of diameter, group A was greater than group B. In the aspects of smoking history, co- morbidities such as hypertension, diabetes, coronary heart disease, COPD, cancer, active tuberculosis and chronic renal insufficiency, the two groups had balance. Comparison of perioperative conditions: compared with group A, in the operation time, blood loss, intraoperative blood transfusion, ICU treatment time, postoperative hospital stay, post- operative complications and hospital costs, group B was significantly better than group A, there were significant differences between the two groups (P < 0.05). However, in the way of postoperative graft-related interventions, the incidence of group A was less than group B and the types of intervention less than group B too. Survival of both groups: the two groups of patients were all survived in the perioperative period, 24-month survival rate of group A was higher than that of group B, there was no significant difference between group A and group B in the perioperative survival rate and the cumulative survival rate (P > 0.05).Conclusion: there were obvious benefits for endovascular in the ways of anes- thesia, surgical trauma, operative time, intraoperative blood loss and blood transfusion, postoperative recovery and hospital stay, so it had advantages for senior citizens and high- risk patients. However, traditional open surgery with less hospital costs, long-term positive effect and the generally suitable for the crowds. Meanwhile, the traditional open surgery in the postoperative interventions was better than endovascular repair. There was no signify- cant difference between two groups in the cumulative survival. Therefore, for different patients, many factors should be considered to select the appropriate surgical intervention. |
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