[A comparative study on transabdominal versus retroperitoneal approach for abdominal aortic surgery].
OBJECTIVE
To retrospectively compare transabdominal with retroperitoneal approach to the aorta for infrarenal aortic reconstruction.


METHODS
From January 1988 to December 1996, Patients undergoing surgery for abdominal aortic aneurysm (AAA) or aortoiliac occlusive disease (AIOD) were included in the retrospective comparison of transabdominal approach (TAA) with retroperitoneal approach (RPA) for aortic surgery. Forty-four patients were analyzed, with 26 (23 with AAA and 3 with AIOD) in TAA group and 18 (16 with AAA and 2 with AIOD) in RPA group. There were no significant differences between the groups in terms of age, sex, comorbid conditions, and vascular graft anastomoses.


RESULTS
The incidence of intraoperative complications was similar for both groups. Postoperatively, RPA group had significantly fewer overall complications than TAA group (P < 0.01). The incidence of prolonged ileus (6 cases in TAA group, none in RPA group) and small bowel obstruction (2 cases in TAA group, none in RPA group) was higher in the TAA group (P < 0.01). Postoperatively four deaths occurred with two in each group. There was no difference in pulmonary complications (P = 0.70). In long-term follow-up (mean 32 months), no significant difference was found in incisional hernias in the two groups.


CONCLUSIONS
RPA approach, with fewer postoperative complications, short stay in the hospital and intensive care unit, is a safer and simpler approach for abdominal aortic surgery.
Jing
Z
Z
Department of Vascular Surgery, Changhai Teaching Hospital, Second Military Medical University, Shanghai 200433.
Cao
G
G
Ye
B
B
D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures / Q000379:methods