Left retroperitoneal approach using a retractor to repair abdominal aortic aneurysms: a comparison with the transperitoneal approach

Abstract

Purpose: The purpose of this study was to compare the effectiveness of the retroperitoneal approach (RP) using a Thompson retractor with the conventional transperitoneal approach (TP), to repair infrarenal abdominal aortic aneurysms (AAA).

Methods: A total of 91 consecutive patients were divided into two groups; group A ( n = 21) underwent surgery using the TP, and group B ( n = 70) underwent surgery using the RP with a Thompson retractor.

Results: There were no significant differences in the operation time, aortic cross-clamp time, incidence of postoperative cardiac events, or the development of wound complications; however, a significantly higher rate of postoperative respiratory complications and ileus was observed in group A. Moreover, oral feeding was commenced later and the hospital stay was prolonged in group A ( P < 0.01).

Conclusion: These findings clearly demonstrate that our RP method, especially when using a Thompson retractor, is a preferable alternative to TP for AAA surgery.