Study On The Relationship Between Surgical Methods And Prognosis Of Abdominal Aortic Aneurysm

Objective: By comparing open surgery repair(OSR)and endovascular aneurysm repair(EVAR)in the treatment effect,health and economic indicators,postoperative survival,etc.,explore the best surgical method for abdominal aortic aneurysm.Methods: To retrospectively analyze the clinical data of patients with abdominal aortic aneurysm who underwent surgical treatment from June 2012 to December 2020 in the Department of Vascular Surgery,First Affiliated Hospital of Guangxi Medical University,and compare the baseline data and diseased blood vessels of the OSR group and the EVAR group of abdominal aortic aneurysm Anatomical measurement results,perioperative conditions,postoperative systemic complications,postoperative graft complications,postoperative reoperations,postoperative survival and death and other indicators were compared and analyzed the differences in curative effect between the two surgical methods.Results: A total of 294 subjects were included in the study,including 28 in the OSR group,266 in the EVAR group,267(90.8%)male patients,27 female patients(9.2%),with an average age of 69.3±9.8 years old,and the median maximum tumor diameter It was 56(47-68)mm,and the median follow-up time was 24(10-52)months.The average age of the EVAR group was significantly higher than that of the OSR group(70.4±8.8 VS 58.4±11.8,P<0.001);the proportion of men in the EVAR group was significantly higher than that of the OSR group(92.1% VS 78.6%,P=0.044).Regardless of whether it was before or after PSM(Preference Score Matching),intraoperative blood loss,intraoperative blood transfusion,anesthesia time,operation time,postoperative blood transfusion,postoperative fasting,postoperative hospital stay,postoperative lungs in the EVAR group The incidence of complications and the incidence of postoperative acute renal failure were significantly lower than those of the OSR group(P<0.05);however,the total hospitalization expenses,postoperative graft complications rate and postoperative mid-to long-term reoperation rates in the EVAR group were all Significantly higher than the OSR group(P<0.05);the OSR group and the EVAR group had no statistically significant differences in postoperative survival and short-and long-term mortality(P>0.05).Conclusions: 1.Compared with OSR,EVAR has the advantages of less surgical trauma,convenient operation,quick postoperative recovery,low incidence of postoperative pulmonary complications and acute renal failure,but its total hospitalization costs and postoperative graft complications The incidence and long-term reoperation rate are high.2.OSR and EVAR have similar overall survival benefits.3.For young patients with long life expectancy,choosing open surgery will benefit more.