[Abdominal aortic surgery. Transperitoneal or retroperitoneal approach?].

Area of Science:

• Vascular Surgery
• Surgical Techniques
• Abdominal Aortosclerosis Treatment

Background:

• Abdominal aortosclerosis necessitates surgical intervention, with retroperitoneal and transabdominal approaches being common.
• Patient selection for these approaches considers factors like prior abdominal surgeries.

Purpose of the Study:

• To compare the outcomes of retroperitoneal versus transabdominal surgical approaches for abdominal aortosclerosis.
• To evaluate postoperative complications and recovery metrics between the two surgical routes.

Main Methods:

• Retrospective analysis of 83 patients undergoing surgery for abdominal aortosclerosis over five years.
• Patients were divided into two groups: retroperitoneal approach (34 patients) and transabdominal approach (49 patients).
• Comparison of preoperative characteristics, postoperative complications, and recovery indicators, including time to defecation.

Main Results:

• No significant differences in postoperative complications were observed between the retroperitoneal and transabdominal groups.
• A trend towards earlier defecation was noted in the retroperitoneal approach group.
• The transabdominal approach allowed for incidental detection of an asymptomatic gastric cancer.

Conclusions:

• Neither the retroperitoneal nor the transabdominal approach demonstrated a clear advantage or disadvantage for treating abdominal aortosclerosis.
• The retroperitoneal approach is particularly suitable for patients with a history of laparotomy due to potential adhesions.
• The transabdominal approach offers the benefit of intraoperative examination of abdominal organs for other pathologies.