[Comparative characteristic of surgical approaches for aneurysms of thoracoabdominal aorta]

The surgical approaches for aneurysms of thoracoabdominal aorta are analyzed. Both thoracoretroperitoneal and thoracolaparotomic approaches are appropriate; they are up to quality of visualization and manipulation on low-thoracic part, visceral branches and bifurcation of aorta that is verified by experimental studies (wound depth 11-15 cm, angle of surgical action 100-110 degrees, angle of surgical action axis 80-90 degrees). The level of thoracotomy and type of approach depends on variant of lesion and planned reconstruction. Modified thoracophrenopararectal approach (wound depth 11.4+/-0.2 cm, angle of surgical action 97.0+/-3.7 degrees, angle of surgical action axis 88.0+/-2.0 degrees) is optimal for manipulations on aortic isthmus.