Document Detail


Epidural anaesthesia and mini-laparotomy for the treatment of abdominal aortic aneurysms in patients with severe chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  17685259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The purpose of this study is to compare the use of epidural and general anaesthesia techniques in the treatment of abdominal aortic aneurysms (AAA) through mini-laparotomy in patients with severe chronic obstructive pulmonary disease (COPD). METHODS: Between March 2002 and October 2005, 23 patients with severe COPD underwent elective infrarenal abdominal aortic aneurysm repair. Endovascular therapy could not be established due to financial reasons and health insurance policies. All the operations were performed through mini-laparotomy, using epidural anaesthesia on 10 patients (Group I) and general anaesthesia on the remaining patients (Group II). Pulmonary disease was diagnosed by clinical history and pulmonary function tests. The diagnosis of severe COPD was made with the presence of one or more of the following criteria : Room air PaO2 < or = 60 mmHg, PaCO2 > or = mmHg in arterial blood gas samples, FEV1 < or = 50% of predicted value and FVC < or = 75% of predicted value in respiratory function tests. RESULTS: There was no significant difference between the ages, sex, pre-operative morbidity status, operation time and total blood loss of the patients in the two groups. Postoperative intensive care unit requirement, postoperative pulmonary complications and hospital stay were significantly higher in group II. All patients tolerated surgery safely. There was one in-hospital mortality from group II on the 35th postoperative day due to prolonged entubation and sepsis related to pulmonary infections. There was no late morbidity or mortality related to the technique in the postoperative follow-up period of the discharged patients. CONCLUSION: Epidural anaesthesia for abdominal aortic aneurysm repair through mini-laparotomy is feasible and should be especially considered in patients with severe COPD where endovascular treatment could not be performed.
Authors:
Y Kalko; M Ugurlucan; M Basaran; U Aydin; U Kafa; T Kosker; M Suren; T Yasar
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Acta chirurgica Belgica     Volume:  107     ISSN:  0001-5458     ISO Abbreviation:  Acta Chir. Belg.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-08-09     Completed Date:  2007-09-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370571     Medline TA:  Acta Chir Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  307-12     Citation Subset:  IM    
Affiliation:
SB BEZM-I Alem Vakif Gureba Hospital, Department Of Cardiovascular Surgery.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anesthesia, Epidural*
Anesthesia, General
Aortic Aneurysm, Abdominal / mortality,  surgery*
Female
Hospital Mortality
Humans
Intensive Care
Length of Stay
Male
Middle Aged
Postoperative Complications / etiology,  mortality,  therapy
Pulmonary Disease, Chronic Obstructive / mortality,  physiopathology*
Retrospective Studies
Surgical Procedures, Minimally Invasive / methods*
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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