Outcome analysis of the surgical team in open surgical repair of intact abdominal aortic aneurysm surgery (2024)

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Gabriele Piffaretti

Vascular Surgery, Department of Medicine and Surgery, University of Insubria School of Medicine and ASST Settelaghi University Teaching Hospital

, Varese,

Italy

Corresponding author. Vascular Surgery, Department of Medicine and Surgery, ASST Settelaghi University Teaching Hospital, University of Insubria School of Medicine, Via Guicciardini 9, 21100 Varese, Italy. Tel: +39-0332-393.259; fax: +39-0332-278.581; e-mail: gabriele.piffaretti@uninsubria.it (G. Piffaretti).

https://orcid.org/0000-0002-9906-4658

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Alessandro Zammito

Vascular Surgery, Department of Medicine and Surgery, University of Insubria School of Medicine and ASST Settelaghi University Teaching Hospital

, Varese,

Italy

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Luca Guzzetti

Anesthesia and Palliative Care, ASST Settelaghi University Teaching Hospital

, Varese,

Italy

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Gabriele Selmo

Anesthesia and Palliative Care, ASST Settelaghi University Teaching Hospital

, Varese,

Italy

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Simone Binda

Anesthesia and Palliative Care, ASST Settelaghi University Teaching Hospital

, Varese,

Italy

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Abstract

OBJECTIVES

To analyze how the experience of the surgical team went to impact the outcomes after open surgical repair (OSR) of intact abdominal aortic aneurysms (AAAs).

METHODS

This is a single-center, observational cohort study with retrospective analysis of all OR for intact AAA performed between 1 January 2010 and 31 December 2022. The primary outcome was survival at 30 days and in follow-up, and a composite outcome of mortality and major complication. The secondary outcome was freedom from aorta-related reintervention. All outcomes were stratified according to the experience of the operating team (surgeons and anesthesiology).

RESULTS

We analyzed 103 (7.2%) patients: 97 (94.2%) males and 6 (5.8%) females. The mean age was 76 ± 8 years (range, 55–93). The best possible team composition was present in 52 (50.5%) interventions. The follow-up index was 0.82 ± 0.18 (range, 0.6–1.0). Mean follow-up duration was 59 ± 43 months (range, 0–158). We observed no differences between teams in major complications (best, 17.3% vs mixed, 21.6%; OR: 0.4, P = 0.622), 30 days mortality (best, 0% vs mixed, 5.9%; OR: 7.6, P = 0.118) and composite outcome (best, 11.5% vs mixed, 17.6%; OR: 0.8, P = 0.416). Cox regression analysis identified the best possible team as a protective factor against the need for reintervention (hazard ratio: 0.2; 95% confidence interval: 0.06–0.88, P = 0.032).

CONCLUSIONS

In our experience, OR of AAA yielded satisfactory results in terms of safety and efficacy independently of the team’s experience. A more experienced team may protect against aorta-related reintervention.

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Surgical team, Companionship, Opensurgicalrepair of abdominal aortic aneurysm

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)

Topic:

abdominal aortic aneurysm
aorta
follow-up
surgical procedures, operative
mortality
composite outcomes

Subject

Aorto-iliac Disease Education (Vascular)

Issue Section:

CONVENTIONAL AORTIC SURGERY

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Outcome analysis of the surgical team in open surgical repair of intact abdominal aortic aneurysm surgery (2024)

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