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Rivista di Chirurgia Cardiaca, Vascolare e Toracica

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The Journal of Cardiovascular Surgery 2014 Sep 30

lingua: Inglese

Abdominal aortic aneurysm treatment: minimally invasive fast-track surgery and endovascular technique in octogenarians

Martelli M. 1, Renghi A. 2, Gramaglia L. 2, Casella F. 1, Brustia P. 1

1 Department of Surgery, Division of Vascular Surgery, Ospedale Maggiore della Carità, Novara, Italy;
2 Department of Anaesthesiology, Ospedale Maggiore della Carità, Novara Italy


AIM: We conducted a retrospective study on patients aged ≥ 80 who underwent elective surgery for an abdominal aortic aneurysm between January 2006 and December 2010. We compared our results with ’Fast-­Track Abdominal Aortic Surgery’ (OPEN surgery) and with endovascular abdominal aortic aneurysm repair (EVAR).
METHODS: We followed 97 consecutive octogenarians affected by abdominal aortic aneurysm who underwent elective surgery. In total, 55 patients were enrolled in the OPEN group (56.7%) and 42 were enrolled in the EVAR group (43.3%).
RESULTS: Eight patients (14.5%) in the OPEN group and six patients in the EVAR group (14.2%) received transfusions. None of the patients required admission to the intensive care unit. In total, 53 patients (98%) in the OPEN group and 34 patients (80%) in the EVAR group were able to get up and walk in the afternoon after the end of surgery. The recovery of intestinal transit was on day 2 in the OPEN group and on day 1 in the EVAR group. Patients in both groups were discharged on average on the 4th postoperative day. There were no perioperative mortalities in the OPEN and the EVAR groups.
CONCLUSIONS: Minimally invasive treatment with the fast-­track protocol and EVAR are both valid options in octogenarian patients because we obtained comparable results in terms of resumption of feeding, early ambulation, days of hospitalization, perioperative rate of mortality and morbidity.

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