ABSTRACT
BACKGROUND: Abdominal aortic aneurysm (AAA) is a life-threatening condition. Open surgery and endovascular repair are the options for treating AAA. This study aimed to compare the frequencies of in-hospital complications and outcomes in two groups of patients who underwent AAA repair surgery using either an open or an endovascular repair method. METHODS: This retrospective study was conducted on the records of 60 patients with AAA undergoing elective surgery repair using endovascular approaches or open surgery at Razi Hospital from 2010 to 2019. Patients' related information, including age, sex, changes in blood pressure, respiratory complications, renal complications, myocardial infarction, paraplegia, cloneischemia, lower limb ischemia, duration of hospital stay in intensive care unit and hospital, the dose of packed RBC, the dose of injectable narcotic analgesics, the need for vasopressor medication, duration of surgery, duration of postoperative oral feeding, and death during hospitalization were assessed. RESULTS: A total of 60 patients in two groups were studied. The mean age of patients was 72.4 ± 6.28 years, and most were male (86.7%). The incidence of renal complications (3.3%) and respiratory complications (0%), rate of decrease in arterial blood oxygen saturation, length of stay in ICU (median 2 vs. 4) and hospital (median 4.5 vs. 7), the need for vasopressor injection and the dose of packed RBC (median 0.4 vs. 3.33), the dose of narcotic analgesic injection (53.3%), duration of surgery (median 2.5 vs. 3), duration of postoperative oral feeding (median 23 vs. 54), and the incidence of death were significantly lower in the endoscopic surgery group. CONCLUSION: Endovascular surgery repairing the rupture of an AAA is associated with fewer postoperative complications and in-hospital death than open surgery.
ABSTRACT
BACKGROUND: The most common cause of primary spontaneous pneumothorax (PSP) is subpleural bleb apical rupture. Little is known about the relationship between PSP and exercise and return to exercise the time. In this study, we tend to investigate the relationship between training and PSP and time of return to exercise and previous activities. METHOD: This study was designed as a case series and the sample size included all patients diagnosed with PSP in Razi and Poursina and Aria hospitals of Rasht during 2015-2017 based on inclusion criteria. Variables were analyzed using Fisher's exact test, Chi-square, Mann Whitney U and t-test (p<0.05). RESULTS: The most common treatment type in patients was transaxillary thoracotomy with pleurodesis with iodine (TTP) in 58.2% and tube thoracostomy and pleurodesis in 41.7%, which was not statistically significant between athletes and non-athletes (p=0.806). Athletes who underwent TTP after four weeks and those treated with tube thoracostomy and pleurodesis after 8-12 weeks were advised to return to their previous activity. Of athletes, 9.5% had a recurrence; of non-athletes, 9.8% had a recurrence. Of athletes, 4.8% did not tolerate returning to their last activity; of non-athletes, 7.3% did not tolerate returning to their previous activity regardless of treatment, and this difference was not significant. CONCLUSION: Our study showed no significant difference between clinical manifestations and image findings and the frequency of treatment and complications in both athlete and non-athlete patients. There is no increase in recurrence and intolerance at the time recommended for return to previous activity.
