[Objective criteria for the invasive nature of a mini-approach in aortofemoral reconstructions. A prospective study]

The authors carried out a prospective study of the invasive nature ofaortofemoral reconstruction performed via the standard routine laparotomy (StLT, Group I, n 10) and minilaparotomy (MLT, Group II, n = 10). It was determined that the objective criteria for the invasive degree of the intervention were less pronounced in the group of the patients operated on through the MLT, with the main differences manifesting themselves to a greater extent in the early postoperative period. Despite statistically significant differences of the creatinphosphokinase (CPK) level as a marker of a parietal injury (562 U/I in Group 1, 243 U/I in Group II, P = 0.005), the concentration of Cortisol increased dramatically during the operation (by 288 and 162%, respectively) with a statistically insignificant deference between the groups (P = 0.08). Alterations in the vegetative status (determined by cardiointervalography) in the intraoperative period were ofa variously directed variable character, not differing between the groups. However, normalization ofthese parameters in the postoperative period occurred more rapidly in MLT. Group IH patients were noted to restore earlier the function of the gastrointestinal trapt with a less pronounced pain syndrome tested by the visual analogue scale, especially on postoperative days 2 and 4 (p<0.01 and. Hence, reconstruction of the infrarenal aorta through the MLT is characterized by a lesser invasive nature, with the above mentioned differences being more pronounced in the early postoperative period, since the main intraoperative factors of the invasion depend to a lesser extent on the approach size.