Clinical outcome of early relaparotomy after elective open repair of abdominal aortic aneurysms

Youngjin Han; Tae-Won Kwon; Gi-Young Ko; Hojong Park; Ji Yoon Choi; Yong-Pil Cho

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자료유형: 학술저널

저자정보: Youngjin Han (University of Ulsan College of Medicine) Tae-Won Kwon (University of Ulsan College of Medicine) Gi-Young Ko (University of Ulsan College of Medicine) Hojong Park (Ulsan University Hospital) Ji Yoon Choi (University of Ulsan College of Medicine) Yong-Pil Cho (University of Ulsan College of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.88 No.3

발행연도: 2015.2

수록면: 160 - 165 (6page)

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Purpose: The aim of this study was to retrospectively evaluate the association of need for early relaparotomy with clinical outcomes after elective open repair of abdominal aortic aneurysms (AAAs).
Methods: A total of 292 consecutive patients who underwent elective open AAA repair at Asan Medical Center from January 2001 to December 2010 were included in this study, and we compared the demographics, clinical characteristics, related risk factors, and clinical outcomes of early relaparotomy versus nonrelaparotomy patients.
Results: The incidence of early relaparotomy during a single hospital stay was 4.1% (n = 12), and the most common causes were bowel ischemia (n = 5, 41.7%) and postoperative bleeding (n = 3, 25.0%). Among the demographics and clinical characteristics significantly associated with relaparotomy were: age (P = 0.025), chronic obstructive pulmonary disease (COPD) (P = 0.010), number of RBC units transfused during the AAA repair (P = 0.022) and in the following week (P = 0.005), and length of intensive care (P < 0.001) and overall hospital stay (P < 0.001). On multivariate analysis, presence of COPD (P = 0.009) and number of RBC units transfused during the AAA repair (P = 0.006) were statistically significantly associated with relaparotomy. Furthermore, early relaparotomy was associated with perioperative (within 30 days) (P = 0.048) and overall in-hospital mortality (P = 0.001).
Conclusion: Early relaparotomy has an adverse effect on clinical outcomes: increased mortality and hospital length of stay. Presence of COPD and need for RBC transfusion are associated with early relaparotomy.

#Abdominal aortic aneurysm #Vascular surgical procedures #Laparotomy #Treatment outcome

참고문헌 (20)

참고문헌 신청

1. [학술지(정기간행물)] - Henebiens M. / 2008 / Elective surgery of abdominal aortic aneurysms in octogenarians : a systematic review / J Vasc Surg 47 : 676 ~ 681

2. [학술지(정기간행물)] - Grant SW. / 2011 / Logistic risk model for mortality following elective abdominal aor t ic aneurysm repair / Br J Surg 98 : 652 ~ 658

3. [학술지(정기간행물)] - Schermerhorn ML. / 2008 / Endovascular vs. open repair of abdominal aortic aneurysms in the Medicare population / N Engl J Med 358 : 464 ~ 474

4. [학술지(정기간행물)] - Lederle FA. / 2009 / Outcomes following endovascular vs open repair of abdominal aortic aneurysm : a randomized trial / JAMA 302 : 1535 ~ 1542

5. [학술지(정기간행물)] - Mani K. / 2011 / Treatment of abdominal aortic aneurysm in nine countries 2005-2009 : a vascunet report / Eur J Vasc Endovasc Surg 42 : 598 ~ 607

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