Surgical management of abdominal aortic aneurysms in Poland. A multi-centre study.
Abdominal aortic aneurysm resections were performed on 941 patients between 1987 and 1991 in nine selected university vascular units in Poland. The aim of the study was (1) to determine how grave the problem of abdominal aortic aneurysms is in the main vascular centres in our country, (2) to evaluate the methods of management, (3) to trace the most common postoperative complications, and (4) to estimate results. Hospital mortality rate for 730 elective and urgent resections was 8.2%. The emergency resection mortality rate for ruptured aneurysm was 60.2%. The most common postoperative general complications were: cardiac (178-18.9%), pulmonary (76-8.1%), renal failure (58-6.2%) and cerebrovascular accidents (23-2.4%). The postoperative local complications (113) occurred in 87 (9.2%) patients. The most common were: colon ischemia (22-3.5%), haemorrhage (30-3.2%), acute graft occlusion (22-2.3) and peripheral embolism (19-2%). Sixty-five patients required early reoperation undergoing a total of 74 additional operative procedures. The local complications occurring in analysed material significantly influenced the results. Mortality in reoperated patients was almost twice as high as among those not reoperated (p < 0.01). Analysis of the material revealed no differences in the obtained results of aneurysm surgery in the succeeding years of our study, when expecting improvement in the last years. The cause of this could be treatment of more high risk patients. The absolute number of patients with abdominal aortic aneurysms referred to the unit influenced results.(ABSTRACT TRUNCATED AT 250 WORDS)
Szostek
M
M
Department of General and Thoracic Surgery, Medical Academy, Warsaw, Poland.
Malek
A K
AK
Cierpka
L
L
Glowinski
S
S
Mackiewicz
Z
Z
Michalak
J
J
Noszczyk
W
W
Skora
K
K
Witkiewicz
W
W
Zapalski
S
S
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000401:mortality / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors