Laparoscopic/laparoscopic-assisted abdominal aortic aneurysm (AAA) repair is associated with less post-operative pain, fewer post-operative complications and a quicker return to normal function than open AAA repair

Abstract

s / International Journal of Surgery 12 (2014) S13eS117 S110 for abdominal aortic aneurysm. 14.3% of patients had ankle-brachial pressure indexes (ABPI) carried out. 11.4% of GP were not confident of making the diagnosis, 20% of GPs were not able to or did not institute best medical treatment (BMT) in the community. 20% of patients referred had symptoms limiting lifestyle. Conclusions: We are not meeting the minimum requirements for clinical examination and ABPI measurements. This could be because GP’s often do not feel confident to diagnose IC and we can speculate as to whether education or increasing secondary care provisionwould be most appropriate. 0144: LAPAROSCOPIC/LAPAROSCOPIC-ASSISTED ABDOMINAL AORTIC ANEURYSM (AAA) REPAIR IS ASSOCIATED WITH LESS POST-OPERATIVE PAIN, FEWER POST-OPERATIVE COMPLICATIONS AND A QUICKER RETURN TO NORMAL FUNCTION THAN OPEN AAA REPAIR Philip C. Bennett *, Ijaz Ahmad, Sohail Choksy, Simon MacKenzie, Christopher Backhouse, Adam Q. Howard. Colchester Hospital University NHS Foundation Trust, Essex, UK. Introduction: To compare patient outcomes between laparoscopic/ laparoscopic assisted (LR) and open repair (OR) of AAA in subjects in whom endovascular repair was inappropriate. Methods: All patients undergoing either LR or OR since 2007 were included. Demographics, operative details and patient outcomes were prospectively recorded. Results: 104 patientswere investigated (51 LR; 53OR,median age 72[66-75] years, 92.3%male). The 2 groups had equivalent ages, sex distribution and VPOSSUM scores. LR procedures had longer aortic clamp times and longer operation times than OR ((90[63-120] vs. 76[57-105] minutes, p1⁄40.048) and (330[270-390] vs. 240[180-300] minutes, p 5(p 5 (OR:17.831, 95%CI 2.713117.193; P1⁄40.003) remained significant on multivariable analysis. Conclusions: Failure to respond to TNS devices may be predicted by greater calf circumference and neuropathy score of >5. Identifying such patients can save time and prove cost-effective. 0177: IMPROVING ACUTE VASCULAR ADMISSIONS AT A TERTIARY REFERRAL CENTRE BY IDENTIFYING AND QUANTIFYING DELAYS IN PATIENT CARE Simon Bellringer *, Jiten Patel, Benjamin Pettifer, Matthew Button, Lola Eid. Brighton University Hospital NHS Trust, Brighton, UK. Introduction: 1. To identify delays in surgical and interventional radiology (IR) procedures for acute vascular patients in a regional vascular centre. 2. To quantify these delays based on NCEPOD guidelines (NCEPOD recommendations http://www.ncepod.org.uk/pdf/NCEPODRecommendations. pdf) 3. To make appropriate recommendations to improve the care pathway of these patients Methods: The audit was carried out over a period of one calendar month. All acute vascular patients requiring a definitive radiological or surgical intervention were included. Time of decision to intervene and time of intervention were recorded for each patient. Results: 26 patients were included. Average time from decision to treat surgically to surgical intervention was 23 hours and 3 minutes and for IR was 52 hours and 33 minutes. The longest wait recorded was 116 hours and 12 minutes (for an IR procedure over a 4 day bank holiday weekend) Conclusions: This audit identified significant delays in definitive treatment for some patients due to shared CEPOD lists and limited availability of IR services. These findings highlight some of the challenges that regional centres face when an increase in service demand precedes the required expansion of services. Recommendation for additional IR sessions and a dedicated vascular CEPOD list were made. 0195: SYSTEMIC INFLAMMATORY RESPONSE SYNDROME SCORE MAY INDICATE INCREASED RISK OF MAJOR AMPUTATION IN PATIENTS WITH DIABETIC FOOT INFECTION Jon Griffin *, Rachel Williams , Chinonso Nwoguh , Perbinder Grewal . Perth Royal Infirmary, Perth, UK; Queen Alexandra Hospital, Portsmouth,