Abstract
Background. This study evaluated a less invasive technique for exposure of the infrarenal aorta
and its impact on the treatment of patients with abdominal aortic aneurysms (AAA)
or aortoiliac occlusive disease (AIOD), or both. Methods. Forty patients with AAA (26), aneurysmal extension into the iliac arteries (6), or
AIOD (8) were prospectively selected for minilaparotomy aortic exposure and repair
using a small periumbilical midline incision (≤10 cm); intra-abdominal, nondisplaced
retraction of the small bowel; and conventional hand-sewn vascular anastomoses. Perioperative
comparisons with a contemporary group of AAA patients treated with long, open midline
incision and extracavitary small bowel retraction were made. Results. There was no significant difference between the minilaparotomy and open surgical
control groups for operating room time; intraoperative, perioperative morbidity; or
mortality. Significant differences were documented between the minilaparotomy and
the control group with regard to stay in the intensive care unit (days; 1.0 ± 1.2
versus 1.8 ± 1.5); return to general diet (days; 3 ± 1.3 versus 4.7 ± 2.8); and length
of stay (days; 4.9 ± 1.8 versus 7.3 ± 3.4). Conclusions. Minilaparotomy exposure is safe and effective for treatment of infrarenal AAA and
AIOD. This technique maintains quality outcome while reducing postoperative ileus,
hospital stay, and resource utilization. (Surgery 2000;128:751-6.)
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Article info
Footnotes
*Reprint requests: William D. Turnipseed, MD, Professor, Department of Surgery, Section of Vascular Surgery, University of Wisconsin Hospital and Clinics, H4/730 CSC, 600 Highland Ave, Madison, WI 53792.
**Surgery 2000;128:751-6
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
