Retroperitoneal access for abdominal aortic aneurysms: a single center experience

Area of Science:

• Vascular Surgery
• Surgical Outcomes
• Aortic Aneurysm Repair

Background:

• Abdominal aortic aneurysms (AAA) require surgical management, particularly for patients ineligible for endovascular aneurysm repair (EVAR).
• Open surgical repair remains a critical treatment modality for AAA.

Purpose of the Study:

• To retrospectively compare postoperative outcomes and survival rates of transperitoneal (TP) versus retroperitoneal (RP) approaches for AAA repair.
• Evaluate the efficacy of different surgical approaches in managing AAA.

Main Methods:

• Retrospective analysis of 840 AAA patients from 1996-2011.
• Comparison of 193 patients in the TP group versus 367 patients in the RP group who underwent open surgical repair.
• Assessment of short- and long-term postoperative outcomes and survival.

Main Results:

• The RP group experienced significantly fewer ICU admissions and postoperative complications (respiratory, cardiac).
• Earlier canalization, oral feeding, and shorter hospital stays were observed in the RP group.
• The RP group demonstrated significantly higher survival rates at 12 and 180 months compared to the TP group.

Conclusions:

• The retroperitoneal approach for AAA repair is associated with superior outcomes, especially in high-risk patients.
• This approach offers a viable alternative for patients unsuitable for endovascular procedures.
• Maintaining surgical expertise is crucial for selecting the optimal AAA treatment strategy.