Why the study?
Does surgical treatment improve survival compared to non-surgical management in patients with abdominal aortic aneurysms?
Does surgical treatment improve survival compared to non-surgical management in patients with abdominal aortic aneurysms?
Early surgical intervention for abdominal aortic aneurysms significantly improves 5-year survival compared to non-surgical management, which is associated with a high rate of fatal rupture.
May support surgery in non-ruptured AAA; hypothesis-generating and requires randomized confirmation before practice change.
An 18-year retrospective review was done to evaluate surgical treatment and remote death in a total of 135cases of abdominal aneurysm, which was divided into surgical and nonsurgical groups. The surgical group consisting of 112 cases was subdivided into ruptured group (16 cases) and non-ruptured one (96). The mean age at surgery was 72 years in the ruptured subgroup or 68 years, in the non-ruptured subgroup. Operative death occurred in 4.2% in the non-ruptured and 62.5% in the ruptured subgroup. Operative death occurred in 4.2% in the non-ruptured and 62.5% in the ruptured subgroup. months, postoperatively. While 2 remote deaths occurred in the ruptured subgroup. The non-surgical group was consisted of 23 patients with mean age of 74.1 years who could not undergo surgery because of high risks or their refusals. In this group 15 remote deaths occurred and seven (47%) of the 15 died of rupture. It took 1.76 years on the average from the initial examination to the rupture occurrence. The 5-year cumulative survival rate was 76% in the group undergone palliative surgery while 22% in the non-surgical group. Thus the demonstrated poor prognosis of the non-surigical group indicates a neccess of early surgery for abdominal aortic aneurysm.
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Shirakata et al. (1990) studied this question.
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