RESUMO
OBJECTIVE: To improve postoperative outcomes in patients with abdominal aortic aneurysms undergoing abdominal aorta replacement via mini-laparotomy by preoperative planning of localization and optimal length of incision. MATERIAL AND METHODS: There were 40 patients with abdominal aortic aneurysms who underwent abdominal aorta replacement via mini-laparotomy. Preoperative planning of mini-laparotomy was carried out in the main group (n=17), empirical mini-laparotomy - in the control group (n=23). Intraoperative parameters, postoperative recovery, complications, and conversion rate were evaluated. RESULTS: Significant differences were observed for conversion rate, duration of surgery and mechanical ventilation. Baseline characteristics and postoperative morbidity were similar. CONCLUSION: Preoperative planning of optimal length of skin incision and analysis of anterior abdominal wall topography using CT angiography significantly reduce duration of surgery, mechanical ventilation and conversion rate. Postoperative morbidity was similar in both groups. Thus, this approach should be used to assess advisability of mini-laparotomy in patients with abdominal aortic aneurysms.
