Abdominal aortic aneursym: stent graft vs clinical pathway for direct retroperitoneal repair

Archives of Surgery
David A RigbergWesley S Moore

Abstract

Endovascular repair (EVAR), while not reducing mortality, has the advantages of reduced morbidity, shorter hospitalization, and quicker recovery when compared with open repair. These advantages must be balanced against increased cost, the risk of early- and late-onset endoleak, and the occasional need for secondary intervention or conversion to open repair. While continuing to offer EVAR, we have also developed a clinical pathway for open repair, which includes a retroperitoneal (RP) approach, nonroutine intensive care unit stay, no nasogastric tube, oral feedings beginning on the first postoperative day, and a hospital discharge between 3 and 5 days postoperatively. Direct repair using the RP approach and a clinical pathway is competitive with EVAR.Method Retrospective review of all RP and EVAR abdominal aortic aneursym procedures performed between January 2001 and December 2002. Eighty-nine RP and 61 EVAR abdominal aortic aneursym repairs were performed. There were no deaths in either group. Results suggest that a clinical pathway including an RP approach resulted in a safe, effective, and rapid hospital discharge in most patients. While EVAR continues to yield a shorter hospital stay and fewer complications when compared wit...Continue Reading

Citations

May 28, 2005·Vascular and Endovascular Surgery·Christopher J AbularrageDipankar Mukherjee
Feb 1, 2007·International Journal of Clinical Practice·Y C ChanP R Taylor
May 1, 2008·The British Journal of Surgery·R E LovegroveR B Galland
Feb 26, 2011·Annals of Biomedical Engineering·John H AshtonJonathan P Vande Geest
May 27, 2009·Annals of Vascular Surgery·Joseph J RicottaGustavo S Oderich

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