Decreased morbidity associated with retroperitoneal exclusion treatment for abdominal aortic aneurysm

A prospective randomized study has been carried out to compare the retroperitoneal (RP) and the transperitoneal (TP) approaches to infrarenal abdominal aortic aneurysms (AAA). From November 1988 to July 1989, 27 patients were randomized to one or the other group. Twelve patients underwent TP resection of their AAA; 11 of these were performed using the open aneurysmorrhaphy technique. The RP approach was used in 15 patients, 12 of whom had the exclusion technique performed. Enteral feeding was resumed on the second postoperative day in the RP group compared to the fourth postoperative day in the TP group; the difference was statistically significant (p less than 0.02). Statistically significant differences were also present in the estimated blood loss (516 cc in the RP group versus 1127 cc in the TP group) in the blood transfusion requirement (p less than 0.05). This prospective randomized study comparing TP and RP approaches to AAA showed that the RPE approach had less blood loss, less transfusion requirement, and earlier resumption of enteral feeding than the TP approach. We feel the RPE technique is safe and efficient in the treatment of infrarenal abdominal aortic aneurysm.