Treatment Strategies for Improving Surgical Outcomes of Ruptured Abdominal Aortic Aneurysm

PurposeWe examined the surgical outcomes at our hospital and considered strategies for improving surgical outcomes for ruptured abdominal aortic aneurysm.MethodsWe examined 95 surgical cases of ruptured abdominal aortic aneurysm performed from January 2009 to December 2020.We examined the preoperative characteristics hospital mortality, postoperative complications and long-term results. Results24 were dead in hospital (hospital mortality 25.2%). The majority of the causes of death were hemorrhage/DIC and intestinal necrosis. 10 cases required preoperative aortic clamp by thoracotomy or insertion of intra-aortic balloon occlusion and 8 of them died. 10 cases required open abdominal management and 5 of them died. Examining the long-term results of the open repair group and the EVAR group, there was no significant difference between the two groups. ConclusionsIn order to improve the surgical outcomes of ruptured abdominal aortic aneurysm, it is necessary to start surgery immediately in a situation where hemodynamics is stable. Whether to select open surgery or EVAR as the surgical method should be selected by each hospital so that it can be started immediately. In order to prevent postoperative intestinal necrosis, it is necessary to consider risk factors of acute compartment syndrome and actively introduce open abdominal management.