Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492006000200005
Jornal Vascular Brasileiro
Artigo Original

Tratamento cirúrgico dos aneurismas da aorta abdominal: existe diferença dos resultados entre homens e mulheres?

Surgical treatment of abdominal aortic aneurysms: is there difference in the results obtained in men and women?

Telmo Pedro Bonamigo; Márcio Luís Lucas; Nilon Erling Jr.

http://dx.doi.org/10.1590/S1677-54492006000200005 J Vasc Bras, vol.5, n2, p.101-108, 2006
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Resumo

OBJETIVO: Avaliar os resultados cirúrgicos após o tratamento convencional e eletivo do aneurisma da aorta abdominal, verificando se existe diferença entre homens e mulheres na mortalidade e morbidade cirúrgicas, bem como nos resultados a longo prazo. PACIENTES E MÉTODOS: Entre dezembro de 1983 e dezembro de 2003, 675 pacientes foram submetidos ao tratamento cirúrgico do aneurisma da aorta abdominal infra-renal, sendo divididos em dois grupos: homens (n = 575) e mulheres (n = 100). Os dados demográficos e aqueles relacionados ao procedimento cirúrgico, bem como os resultados perioperatórios, foram coletados pela revisão dos prontuários. Os pacientes com alta hospitalar formaram uma coorte retrospectiva, onde foram avaliadas as causas tardias de óbito e a sobrevida. RESULTADOS: A média das idades foi similar, sem diferença estatística entre mulheres e homens (68,9 ± 9,1 versus 67,4 ± 7,1 anos; P = 0,089). A presença de hipertensão arterial foi significativamente superior nas mulheres (73 versus 62,4%; P = 0,042), e a cardiopatia isquêmica e história de tabagismo foram mais freqüentes nos homens (P <0,05). A mortalidade operatória total foi de 2,8%, não havendo diferença significativa entre mulheres e homens (4 versus 2,6%, respectivamente; P = 0,43). A morbidade cirúrgica envolveu 14% dos pacientes femininos e 18,4% dos masculinos (P 0,05). A taxa de sobrevida global em 1, 3, 5 e 10 anos não diferiu entre os grupos, sendo a sobrevida em 5 anos de 71% para as mulheres e 72% para os homens (P 0,05). A principal causa de morte tardia foi de origem cardiovascular, seguida de complicações renais nas mulheres e neoplasia nos homens. CONCLUSÂO: A taxa de mortalidade e morbidade cirúrgicas não aumentou significativamente nas mulheres após a correção eletiva do aneurisma da aorta abdominal infra-renal. Além disso, os resultados a longo prazo são semelhantes entre os dois gêneros.

Palavras-chave

Aneurisma da aorta abdominal, cirurgia, mulheres

Abstract

OBJECTIVE: To evaluate perioperative results in patients submitted to elective conventional open repair of abdominal aortic aneurysm, comparing the results between women and men in relation to perioperative mortality and morbidity, as well as long term outcomes. PATIENTES AND METHODS: Between December 1983 and December 2003, 675 patients were submitted to infrarenal abdominal aortic aneurysm repair. We divided these patients into two groups: men (n = 575) and women (n = 100). Demographic and operative data, as well as perioperative outcomes were obtained from chart review. Discharged patients formed a retrospective cohort, in which the late causes of death and survival were evaluated. RESULTS: The mean age was similar, but no statistical difference was observed between men and women (68.9 ± 9.1 versus. 67.4 ± 7.1 years; P = 0.089). The presence of hypertension was significantly higher in women (73 versus 62.4%; P = 0.042), and coronary artery disease and history of smoking were more prevalent in men (P <0.05). The overall mortality rate was 2.8%, without any significant difference between women and men (4 versus 2.6%, respectively; P = 0.43). Perioperative morbidity was similar in both groups (14% for women; 18.4% for men; P 0.05). The survival rates in 1, 3, 5, and 10 years were similar in the groups, with a 5-year survival of 71% for women and 72% for men (P 0.05). Cardiovascular disease was the main late death cause in both groups, followed by renal complications in women and neoplasia in men. CONCLUSION: Perioperative mortality and morbidity rates did not significantly increase in women after conventional infrarenal abdominal aortic aneurysm repair. Furthermore, long term results were similar in both genders.

Keywords

Abdominal aortic aneurysm, surgery, women

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