Left Thoracotomy before Laparotomy for Ruptured Abdominal Aortic Aneurysm.

VernacularTitle:破裂性腹部大動脈りゅうの外科治療における左開胸併用法の有用性
Author: Taijiro Sueda ; Kazumasa Orihashi ; Takayuki Nomimura ; Saiho Hayashi ; Yoshiharu Hamanaka ; Yuichiro Matsuura
Publication Type:Journal Article
From:Japanese Journal of Cardiovascular Surgery 1994;23(2):88-91
CountryJapan
Language:Japanese
Abstract: Twelve cases of ruptured abdominal aortic aneurysm (RAAA) were treated during 5 years. Nine showed severe hypotension (systolic pressure below 70mmHg) and three required cardiac massage prior to operation. At the beginning of this study, direct laparotomy was conducted on 4 cases but mortality was high mortality (75%). Left thoracotomy with antero-lateral incision through the 7th intercostal space was carried out to access the thoracic aorta for clamping before laparotomy, since the major mortality of this disease is due to abrupt bleeding following anesthesia and operation. Left thoracotomy before laparotomy was conducted on 8 cases, half of whom required aortic clamping during operation (clamping time 21min). Operative mortality following thoracotomy decreased (12.5%). The aneurysm size and the time of operation for the groups with or without thoracotomy were the same, though the degree of bleeding significantly differed (3, 925ml in the group with thoracotomy, 7, 193ml in the group without thoracotomy). Left thoracotomy befor laparotomy obtained good results in case of RAAA.