title: Abdominal aortic aneurysm treatment: minimally invasive fast-track surgery and endovascular technique in octogenarians.
abstract: BACKGROUND
  We conducted a retrospective study on patients aged over eighty 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 group) and with endovascular aneurysm repair (EVAR group).
  
  
  METHODS
  We followed 97 consecutive octogenarians affected by abdominal aortic aneurysm who underwent elective surgery. A total of 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 fourth 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.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Ospedale Maggiore della Carità, Novara, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Martelli
authors.affiliation: Department of Anesthesiology, Ospedale Maggiore della Carità, Novara, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Renghi
authors.affiliation: Department of Anesthesiology, Ospedale Maggiore della Carità, Novara, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Gramaglia
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Ospedale Maggiore della Carità, Novara, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Casella
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Ospedale Maggiore della Carità, Novara, Italy - brustiapiero@aruba.it.
authors.forename: Piero
authors.initials: P
authors.lastname: Brustia
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D018579:Patient Selection; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome