Respiratory function after aortic aneurysm repair: a comparison between retroperitoneal and transperitoneal approaches.
OBJECTIVE
Elective abdominal aneurysm repair can be performed by using the transperitoneal or the retroperitoneal approach. The latter has been described as having a better outcome, reducing the impairment of respiratory function or the incidence of lung complications. Hence, the retroperitoneal approach has been proposed for treatment of medically high-risk patients. However, the superiority of one technique or the other in preserving pulmonary function has not been conclusively demonstrated. The aim of this study was to ascertain whether the retroperitoneal and the transperitoneal approaches affect respiratory function differently.


METHODS
A prospective randomized study.


METHODS
Two four-bed surgical-medical ICUs of a University hospital.


METHODS
Twenty-three consecutive patients undergoing abdominal aortic aneurysm repair were randomized to the retroperitoneal (12 patients) and transperitoneal approach (11 patients). They were studied: a). within 30 min the end of surgery; b). 8 h after the end of surgery; and c). during a T-piece tube-weaning trial.


METHODS
The comparison between the two groups was based on respiratory mechanics, partitioned between lung and chest wall components, basic spirometry, tension-time index of the inspiratory muscle, weaning indexes, and length of stay both in ICU and hospital.


RESULTS
The two surgical techniques do not differ in their impact on either respiratory mechanics or inspiratory muscle function or weaning indexes. However, there was a tendency for retroperitoneal patients to stay for less time both in ICU and in the hospital.


CONCLUSIONS
During the first 24 h after surgery, the postoperative impairment of respiratory function is independent of the surgical approach.
Volta
Carlo A
CA
Department of Surgical, Anaesthesiological and Radiological Science, Section of Anaesthesia and Intensive Care, S. Anna Hospital, University of Ferrara, Corso Giovecca n. 203, 44100, Ferrara, Italy. vlc@dns.unife.it
Ferri
Enrico
E
Marangoni
Elisabetta
E
Ragazzi
Riccardo
R
Verri
Marco
M
Alvisi
Valentina
V
Zardi
Silvia
S
Bertacchini
Sara
S
Gritti
Gaetano
G
Alvisi
Raffaele
R
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D012143:Respiratory Physiological Phenomena; D014656:Vascular Surgical Procedures / Q000379:methods*