Resumo

HILLER, Heinz; CAMACHO, Jaime  e  MORENO, Julián. Are there advantages in the extraperitoneal approach for the treatment of abdominal aortic aneurysm?. Rev. Colom. Cardiol. [online]. 2010, vol.17, n.1, pp.33-38. ISSN 0120-5633.

There are current controversies over the benefits of the extraperitoneal vs the transperitoneal approach for repairing an infrarenal abdominal aortic aneurysm. Several studies report a reduction in morbidity and mortality with the former approach. This study reports the short term results using both approaches at one reference center. This is a 12 year, retrospective descriptive study of 299 patients who underwent an elective open repair of an abdominal aortic aneurysm, distributed in two groups: transperitoneal approach group=1, extraperitoneal approach group=2. A total of 93 patients in group 1 and 206 in group 2 were intervened, mainly male patients with an median age of 68 years. The frequencies of co-morbidities were similar in both groups. There was a reduced tendency of reoperations in group 2 (12.9%vs 5.8%), and a greater tendency of postoperative complications in group 1 (30.1% vs 12.6%). However, the types complications were similar. The results show a median hospital stay of 13.3 days (SD+- 10,4) vs. 7.19 days (SD+- 4.20) p=0.00001, median post-operative stay of 9.16 days (SD-+ 8,1) vs. 5.62 days (SD+- 3,46) p= 0.001 and median intensive unit stay of 2.76 days (SD+-4.19) vs 1.56 days (SD+-1.86) p=0.00001 in group 1 y 2 respectively. Early global mortality was 3.3% with a distribution frequency of 6.5% (n=6) in group 1 and 1.9% (n=4) in group 2. In our experience, the extraperitoneal approach offers better results regarding hospital, postoperative and intensive care unit stay, as well as post-operative re-operation rates and complications. Because of the small sample size, the mortality difference was not statistically significant; however, we found an important tendency towards improved mortality rates with this approach.

Palavras-chave : abdominal aortic aneurysm; approach; extraperitoneal; transabdominal; incision; retroperitoneal; transperitoneal.

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