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KMID : 0371420150880030160
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Annals of Surgical Treatment and Research
2015 Volume.88 No. 3 p.160 ~ p.165
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Clinical outcome of early relaparotomy after elective open repair of abdominal aortic aneurysms
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Han Young-Jin
Kwon Tae-Won
Ko Gi-Young
Park Ho-Jong
Choi Ji-Yoon
Cho Yong-Pil
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Abstract
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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.
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KEYWORD
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Abdominal aortic aneurysm, Vascular surgical procedures, Laparotomy, Treatment outcome
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