Comparison between Transabdominal and Retroperitoneal Approach for Reconstruction of the Infrarenal Abdominal Aorta
- Author:
Sung Kyu PARK
1
;
Bo Yang SUH
;
Koing Bo KWUN
Author Information
1. Department of Surgery, College of Medicine, Yeungnam University, Korea.
- Publication Type:Original Article
- Keywords:
Aortoiliac reconstruction;
Retro-& transperitoneal approach
- MeSH:
Aorta, Abdominal;
Hospitalization;
Humans;
Hypertension;
Intubation, Gastrointestinal;
Myocardial Ischemia;
Pulmonary Disease, Chronic Obstructive;
Retrospective Studies;
Wounds and Injuries
- From:Journal of the Korean Society for Vascular Surgery
1997;13(1):21-27
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
To evaluate the efficacy of the retroperitoneal approach when compared with the transperitoneal approach in elective infrarenal aortoiliac reconstruction, retrospective review of consecutive cases was made with multiple intra-and postoperative parameters. Twenty consecutive cases of infrarenal aortoiliac diseases were performed reconstructive surgery from June 1994 to July 1996 at Department of Surgery, Yeungnam University Hospital. Among these patients, 12 cases underwent aortoiliac reconstruction through the transperitoneal approach(8 cases for infrarenal abdominal aortic occlusion and 4 cases for infrarenal abdominal aneurysm) and 8 cases underwent aortoiliac reconstruction through the retroperitoneal approach (5 cases for infrarenal abdominal aortic occlusion and 3 cases for infrarenal abdominal aortic aneurysm). Both groups had similar associated diseases, such as hypertension, myocardial ischemia and COPD. Intraoperative blood loss was minimal and similar in both groups. The intraoperative crystalloid requirements were not significantly higher for the retroperitoneal approach(4800 ml) than the transperitoneal approach(4400 ml)(p>0.05) and perioperative blood requirements were also similar in both groups. The operation time was not taken significantly longer for the retroperitoneal approach(4.4hr) than the trasperitoneal approach(3.9hr)(p>0.05). Nasogastric intubation and initiation of oral feeding was not significantly prolonged in the transperitoneal group(5 days) when compared with the petroperitoneal group(2.5 days)(p>0.05). Postoperative hospitalization was not considerably prolonged in the transperitoneal approach(19 days) when compared with the retroperitoneal approach(16 days)(p>0.05). There noted significant pulmonary complication in the transperitoneal approach group, whereas wound pain was major complication in the retroperitoneal approach group. These experiences demonstrate that the retroperitoneal approach is a preferable alternative to the transperitoneal route in elective aortoiliac reconstruction.
