[The results of resection treatment in infrarenal aneurysms of the abdominal aorta over the last 5 years (1989-1993)].
Abdominal aortic aneurysms (AAA) are a major problem in vascular surgery owing to their ever increasing incidence, asymptomatic course and disastrous complications. The positive postoperative results of elective treatment account for a lowered mortality rate, with life expectancy prolonged as much as twice. However, the results of the operative treatment of AAA on an emergency basis are still unsatisfactory. It is the purpose of this paper to describe hitherto experience and success of the clinic with AAA treatment, and inform the medical circles about the increased potentialities of the management of this unexplored, difficult but still curable disease. Seventy-three patients presenting AAA, operated on during the period 1989-1993, are analyzed. The clinical signs and associated diseases, frequency of clinical forms, preoperative factors influencing the risks of forthcoming operations and the long-term results are comprehensively discussed. An asymptomatic clinical form is observed in 60.5 per cent of the patients (Pt = 0.05). Operative lethality is significantly increased in the event of rupture of the aneurysm, its diameter, angina pectoris symptoms and hypertension (P = 0.01). A standard operative technique, described by Creech, is used. Haemonetics Cell Saver is also employed. Thus, the amount of donor blood is reduced by one third of the volume required without any accidents or fatalities. The causes of postoperative death include: ischemic colitis, myocardial infarction and bronchopneumonia. Thanks to the experience and skill of the surgical and anesthesiological teams, the last five years are marked by a low rate of mortality - 3.7 percent for the elective group, and 12.5 percent for the emergency cases.(ABSTRACT TRUNCATED AT 250 WORDS)