Transperitoneal versus extraperitoneal approach for routine vascular reconstruction of the abdominal aorta.
In this non-randomised retrospective study we have compared 79 cases with transperitoneal approach and 90 cases with extended postero-lateral extraperitoneal approach for elective reconstruction of the infrarenal aorta. In the extraperitoneal group more patients were diabetic (7.8% vs 1.3%, p < 0.05) or had a serum creatinine of more than 1.5 mg % (10.1% vs 2.5%, p < 0.05). The study shows that in spite of a higher proportion of risk factors, a longer preparation (61' vs 44', p < 0.001), dissection (55' vs 46', p < 0.05) and total procedure time (193' vs 173', p < 0.05), the need for more blood transfusion (2.8 U vs 2.3 U, p < 0.05) and colloid perfusion (2.1 L vs 1.8 L, p < 0.05) in the extraperitoneal group, the incidence of complications is not higher compared to the transperitoneal group (29% vs 24%, NS). On the contrary, problems of intestinal transit were found exclusively in the transperitoneal group (7.6%, p < 0.01). Therefore it seems that, as far as the peri- and postoperative period is concerned the extraperitoneal approach might be the technique of choice for the simple elective infrarenal aorta reconstructions.
Lacroix
H
H
Department of Vascular Surgery, University Hospital of Leuven, Belgium.
Van Hemelrijk
J
J
Nevelsteen
A
A
Suy
R
R
D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001803:Blood Transfusion; D001807:Blood Vessel Prosthesis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D012307:Risk Factors