Left retroperitoneal approach using a retractor to repair abdominal aortic aneurysms: a comparison with the transperitoneal approach.
OBJECTIVE
The purpose of this study was to compare the effectiveness of the retroperitoneal approach (RP) using a Thompson retractor with the conventional transperitoneal approach (TP), to repair infrarenal abdominal aortic aneurysms (AAA).


METHODS
A total of 91 consecutive patients were divided into two groups; group A ( n = 21) underwent surgery using the TP, and group B ( n = 70) underwent surgery using the RP with a Thompson retractor.


RESULTS
There were no significant differences in the operation time, aortic cross-clamp time, incidence of postoperative cardiac events, or the development of wound complications; however, a significantly higher rate of postoperative respiratory complications and ileus was observed in group A. Moreover, oral feeding was commenced later and the hospital stay was prolonged in group A ( P < 0.01).


CONCLUSIONS
These findings clearly demonstrate that our RP method, especially when using a Thompson retractor, is a preferable alternative to TP for AAA surgery.
Hioki
Masafumi
M
Department of Surgery, Nippon Medical School Second Hospital, 1-396 Kosugimachi, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan.
Iedokoro
Yoshio
Y
Kawamura
Jun
J
Yamashita
Yasuo
Y
Yoshino
Naoyuki
N
Orii
Kouan
K
Masuda
Sakae
S
Yamashita
Kouji
K
Tanaka
Shigeo
S
D000367:Age Factors; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery; D012187:Retroperitoneal Space / Q000601:surgery; D012189:Retrospective Studies; D013525:Surgical Instruments; D013514:Surgical Procedures, Operative / Q000379:methods*