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Initial experience of abdominal aortic aneurysm repairs in Borneo
Author(s) -
Yii Ming Kon
Publication year - 2003
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1046/j.1445-2197.2003.02668.x
Subject(s) - medicine , surgery , abdominal aortic aneurysm , asymptomatic , elective surgery , mortality rate , aortic surgery , presentation (obstetrics) , aneurysm , aortic aneurysm , general surgery , aorta
Background: Abdominal aortic aneurysms (AAA) repairs are routineoperations with low mortality in the developed world. There arefew studies on the operative management of AAA in the Asian population.This study reports the initial results from a unit with no previousexperience in this surgery by a single surgeon on completion oftraining. Methods: All patients with AAA repair from a prospective databasebetween 1996 and 1999 in the south‐east Asian state of Sarawak inBorneo Island were analyzed. Three groups were identified on presentationaccording to clinical urgency of surgery. Elective surgery was offeredto all good risk patients with AAA of ≥ 5 cm.All symptomatic patients were offered surgery unless contraindicatedmedically. Results: AAA repairs were performed in 69 patients: 32 (46%)had elective repairs of asymptomatic AAA; 20 (29%) hadurgent surgery for symptomatic non‐ruptured AAA; and 17 (25%)had surgery for ruptured AAA. The mortality rate for elective surgery was6%; the two deaths occurred early in the series with thesubsequent 25 repairs recorded no further mortality. The mortalityrates for the urgent, symptomatic non‐ruptured AAA repair and rupturedAAA repair were 20% and 35%, respectively. Cardiacand respiratory complications were the main morbidities.Sixty‐three patients seen during this period had no surgery; threepresented and died of ruptured AAA, 34 had AAA of ≤ 5 cmin diameter, and 26 with AAA of ≥ 5 cmdiameter had either no consent for surgery or serious medical contraindications. Conclusion: This study showed that AAA can be repaired safely byhighly motivated and adequately trained surgeons in a hospital withlittle previous experience.