[Retroperitoneal approach to the abdominal aorta for occlusive disease.]

The abdominal aorta can be approached through the peritoneum or retroperitoneally. The aim of this study was to compare these two routes of exposure. Over a 10 year period, between 1979 and 1989, 48 patients were operated on for an aortobifemoral bypass, because of occlusive diseases of aorta or iliac arteries. The retroperitoneal approach was used in 20 cases and 28 were operated by the standard transperitoneal approach. In a non randomized retrospective study the outcome was compared regarding; operation time, blood transfusion during operation, initiation of alimentation, hospitalisation and mortality. All of the patients were operated on by two experienced vascular surgeons. In the retroperitoneal group there were 11 men and 10 women with a mean age of 63,4 years. In the transperitoneal group there were 16 men and 10 women with a mean age of 60,3 years. With the retroperitoneal approach the operating time was 185 min. v. 248 min. for the transperitoneal group (p<0.05). The fasting period after operation was four days for the retroperitoneal group v. five days for the transperitoneal group (p<0.05). The hospitalization was 11 days when the retroperitoneal approach was used v. 15 days for the transperitoneal group (ns). The results of this study indicate that it is advantageous to approach the abdominal aorta through a retroperitoneal route.