Initial experience of abdominal aortic aneurysm repairs in Borneo

Area of Science:

• Vascular Surgery
• Aortic Aneurysm Management
• Surgical Outcomes in Asia

Background:

• Abdominal aortic aneurysm (AAA) repair is a common procedure in developed countries, but data on Asian populations is limited.
• This study focuses on the initial outcomes of AAA repair performed by a single surgeon in a new unit in Sarawak, Borneo.
• The research addresses the operative management of AAA in an underrepresented demographic.

Purpose of the Study:

• To report the initial results of abdominal aortic aneurysm (AAA) repairs in a South-East Asian population.
• To evaluate the safety and efficacy of AAA surgery in a setting with no prior experience.
• To assess the learning curve and outcomes associated with AAA repair by a newly trained surgeon.

Main Methods:

• A prospective database of all AAA repairs performed between 1996 and 1999 in Sarawak was analyzed.
• Patients were categorized into three groups based on clinical urgency: elective, urgent symptomatic non-ruptured, and ruptured AAA.
• Inclusion criteria included AAA size (>= 5 cm for elective) and medical suitability for surgery.

Main Results:

• A total of 69 AAA repairs were performed, with 32 elective, 20 urgent, and 17 for ruptured aneurysms.
• Mortality rates were 6% for elective, 20% for urgent, and 35% for ruptured AAA repairs, with a notable decrease in early elective cases.
• Cardiac and respiratory complications were the primary morbidities; 63 patients did not undergo surgery due to various reasons.

Conclusions:

• Abdominal aortic aneurysm (AAA) repair can be performed safely in hospitals with limited prior experience.
• Adequate surgical training and high motivation are key factors for successful AAA repair outcomes.
• This study demonstrates the feasibility of establishing safe AAA surgical practices in developing regions.