Abstract
Seven cases undergoing abdominal aortic reconstruction for an abdominal aortic aneurysm or arteriosclerosis obliterans by the extended retroperitoneal incision was reviewed and compared with 10 cases undergoing the standard transperitoneal reconstruction for intraoperative and postoperative parameters. There was no significant differences in operation time, intraoperative bleeding, urine output and intraoperative changes in blood pressure or heart rate between two groups. The retroperitoneal group showed higher intraoperative crystalloid fluid requirements, that was caused by a use of autotransfusion machine and the effect of minimizing transfusion.
Delay before postoperative initiation of oral intake and duration of postoperative hospitalization were considerably shorter in the retroperitoneal group. Although there was no major complications postoperatively in the retroperitoneal group, a patient in the transperitoneal group developed acute renal failure.
The disadvantages of retroperitoneal approach we experienced were: (1) inaccessible right internal and external iliac arteries under the existence of the common iliac aneurysm through left flank incision; (2) need much time for open and close the abdominal wall; and (3) inability to inspect abdominal contents, especially the left side colon after aortic reconstruction.
In conclusion, early ambulation and discharge are possible even in the high risk patients received the retroperitoneal approach, and this method shows good indication for these patients.
