Minimally invasive retroperitoneal approach for the treatment of infrarenal aortic disease.
OBJECTIVE
In order to decrease complications and improve postoperative recovery, we have developed a minimally invasive retroperitoneal approach (MIRPA) for the treatment of infrarenal aortic disease. This study was carried out to define the limitations and applicability of this technique in the treatment of aortoiliac occlusive disease (AIOD) and abdominal aortic aneurysms (AAAs).


METHODS
From November 2000 to February 2004, 150 patients with AAA (n = 130) or AIOD (n = 20) were prospectively included in the study. The procedure consisted in a standard aneurysmorrhaphy or bypass procedure performed through a video assisted left minilombotomy.The main outcomes measured were mortality, complications, operative time, aortic cross-clamp time, time to solid diet, and length of intensive care unit and hospital stay.


RESULTS
Operative mortality was 0.7 %. Nonfatal postoperative complications occurred in 12 patients (8%). Conversion to a standard procedure was necessary in 3 patients. Mean operative time was 207 +/- 57 minutes (AAA) and 224 +/- 55 minutes (AIOD). Mean aortic cross-clamp time was 76 +/- 26 minutes (AAA) and 48 +/- 21 minutes (AIOD). Median resumption of regular diet was 2 days. Median length of stay in the intensive care unit was 1 day and in the hospital 8 days.


CONCLUSIONS
Our results suggest that MIRPA is a safe and effective minimally invasive procedure in the treatment of infrarenal aortic disease.
Piquet
Philippe
P
Department of Vascular Surgery, Hôpital Sainte Marguerite, Marseille, France. philippe.piquet@ap-hm.fr
Amabile
Philippe
P
Rollet
Gilles
G
D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D004691:Endarterectomy / Q000379:methods; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity / Q000601:surgery; D020535:Video-Assisted Surgery / Q000379:methods*