ABSTRACT
In the last decade, 78 patients received operations for abdominal aortic aneurysms with a transperitoneal approach (TP) while in 82 patients we used an extraperitoneal approach (EP). Forty-two patients in the TP group and 40 in the EP group who required no concurrent repair of the inferior mesenteric artery, renal artery or lower extremity arteries were compared. There was no difference between the two groups in mean operative time, mean amount of intraoperative bleeding or mean amount of required homologous blood transfusion. The mean interval after surgery to beginning peroral alimentation and the mean duration of postoperative fluid therapy were significantly shorter in the EP group than in the TP group. An extraperitoneal approach for abdominal aortic reconstruction is preferable for an early postoperative recovery.
ABSTRACT
Two types of skin incision, pararectal and transverse, in the retroperitoneal approach to aorto-iliac region were compared. For the last 3 years, 34 abdominal aortic aneurysms, excluding ruptured cases, and 43 cases of aorto-iliac occlusive disease were all operated on by a retroperitoneal approach in our hospital. Of these, 36 patients underwent pararectal incision (P group) and 41 patients transverse incision (T group). An Octopus<sup>®</sup> retractor yielded a wide operative field in all cases. The mean interval from the start of the operation to the aortic cross clamp were almost equal in the two groups (89.7 and 91.1 minutes). The mean amount of intraoperative bleeding was significantly smaller in the T group (749ml) than in the P group (1, 096ml). The mean interval after surgery to beginning peroral alimentation, weaning from analgesics and discharge from the hospital were all significantly shorter in the T group (1.6, 3.3 and 10.8 days) than the P group (2.8, 4.8 and 15.8 days). Transverse incision for a retroperitoneal approach to the aorto-iliac region is preferable for an early recovery and short hospital stay.
ABSTRACT
A 69-year-old man was admitted because of pyrexia and increased ESR and CRP. Blood culture was positive for Staphylococcus, and CT scan and aortography revealed irregularly shaped abdominal aortic and left common iliac artery aneurysms which grew rapidly. An urgent operation with exclusion and bypass grafting was performed because aneurysms tightly adhered to the surrounding tissues and dissection appeared to be extremely difficult. Administration of antibiotics was continued intravenously, then orally for three months postoperatively, and pyrexia and the increased ESR and CRP disappeared.