Patient Outcomes and ConsiderationsSurgical Complexityendovascular aortic repairopen repairaortic anatomy
What is the length of the stay in hospital after aneurysm repair?
Mr Gibbs talks to Mr Jaffer about the importance of length of stay in hospital after aneurysm repair in deciding whether to opt for endovascular (keyhole) repair or open surgery. With endovascular repair, a lot of patients can expect to be in hospital for about one to two days. But for open repair, because this is a much larger operation, this would need at least one day in intensive care or high dependency units, and another few days in hospital. But it is important to weigh this up against the longer term outcomes of durability, which tend to favour open repair.
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Rick, obviously length of stay is an important factor in people's decision making, but how should you weigh that up against other factors in terms of making up a decision on whether to have an endovascular open affair? It's a really good point and it's one that we perhaps don't think about enough, but if you're a patient then most patients do not like spending time in hospital for obvious reasons and they're as keen as possible to get out. With our endovascular aortic repair program now we can really offer people an enhanced recovery and certain groups of patients will be able to get out within one day, within 23 hours, so they'll barely spend a whole day in hospital. For a lot of patients that's a little bit unrealistic and so for most patients, particularly slightly older age of the spectrum who are undergoing EVAR, they could expect to be in hospital for 48 hours, so two days. It's a very different kettle of fish for open repair, because the patient's going to have between 24 and 48 hours on an intensive care or high dependency unit, and then they'll realistically need another five to six days on a normal ward bed, just recovering. So it's a much longer inpatient stay overall. But again, you've got to set that against the much longer term success and durability of the procedure. So if you are undergoing an open repair because you don't have an aortic anatomy that's suitable for an endomascular repair, you'll probably in the long term save yourself a lot more time, even though the length of hospital stay at the outset is longer.
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