[Abdominal aortic aneurysm treated by endovascular stent graft and conventional surgical repair for overweight and obesity patients: a comparison early result].

OBJECTIVE: To investigate the outcomes in overweight and obesity patients with abdominal aortic aneurysm (AAA) treated with elective open or endovascular repair (EVAR).

METHODS: The clinical data of 52 patients with AAA treated by EVAR (EVAR group, n=17) and conventional surgical repair (open group, n=54) were analyzed retrospectively. Overweight was defined as a body mass index (BMI) between 24 kg/m2 and 28 kg/m2, obesity was defined as a BMI 28 kg/m2. Patients' conditions, operative time, blood loss, function recovery and complications were compared. A two-tailed Student's t-test or rank sum test was used to compare measurement data between the two groups. χ2 test or Fisher exact probability test was used to compare quantitative data between the two groups.

RESULTS: No significant difference were observed in gender, age, other disease, anesthesia risk category, aneurysm type, the maximum aneurysm diameter, and mortality rate between the groups (P>0.05). All patients had success of surgical procedures. Compared with open group the EVAR group had significant reductions in operative time ((449±174) minuets vs. (140±36) minuets), blood loss ((1.8±1.9) L vs. (1.7±1.2) L), units of blood transfusion ((5.3±5.2) units vs. 0), intravenous fluids ((3.3±1.6) L vs. (1.6±1.6) L), need for ventilation ((26.2±10.6) hours vs. (2.3±1.4) hours), intensive care unit stay ((5.2±1.3) days vs. (1.4±0.5) days) and length of stay ((17±9) days vs. (7±3) days) (F=9.932 to 44.816, all P<0.05). Six cases of complications was observed in open group during perioperative, while 9 cases of complications were observed in EVAR group. The difference was significant (χ2=9.572, P=0.008) which open group was significantly higher than the EVAR group. Two patients died during perioperative in open group, however, the EVAR group had no deaths occurred. All complications were connected with the interventional technique. Endoleak was the chief complication after operation. After Follow-up the main complications of infection (n=2), wounds (n=2) and abdominal hernia (n=2) based for open group was observed, and the main complications for EVAR group was endoleak (1 case of type I, 3 cases of type II).

CONCLUSION: EVAR may be preferable in overweight and obesity patients with AAA in the short term.