Key result
The retroperitoneal approach for open surgical repair of abdominal aortic aneurysms provides excellent access and is associated with less post-operative morbidity compared to transperitoneal repair.
Why the study?
The retroperitoneal approach is useful for repairing abdominal aortic aneurysms unsuitable for endovascular repair, but there is a relative lack of familiarity with the technique because it is not widely practiced.
Does the retroperitoneal approach improve outcomes compared to the transperitoneal approach in patients undergoing open surgical repair of abdominal aortic aneurysms?
Does the retroperitoneal approach improve outcomes compared to the transperitoneal approach in patients undergoing open surgical repair of abdominal aortic aneurysms?
The retroperitoneal approach is recommended as a preferred option for open surgical repair of AAAs unsuitable for endovascular repair due to reduced morbidity and shorter hospital stays.
May support retroperitoneal preference in open AAA repair; leaves open need for randomized confirmation.
In the era of endovascular repair of abdominal aneurysms (AAA) the use of traditional open surgical repair of AAA is declining. The preferred option for patients with AAAs who are young or have challenging anatomy that is not suitable for Endovascular repair is open surgical repair. Most Vascular Surgical units are familiar with the transperitoneal (TP) approach to AAA. Another useful approach to AAA is retroperitoneal (RP). Our unit has found RP a more suitable approach for repairing the AAAs with challenging anatomy and in patients with poor physiological function. RP approach provides excellent access to the juxta/supra renal aorta. In addition, patients undergoing RP have less post-operative morbidity and shorter hospital stay compared to those undergoing TP repair. Our unit recommends RP approach as the preferred option to repair AAAs unsuitable for endovascular repair. Given the relative lack of familiarity with this technique as it is not widely practised, we have described the technique/our experience and its advantages over conventional open surgery.
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Haldipur et al. (2020) conducted a review in Abdominal aortic aneurysm (AAA). Retroperitoneal (RP) approach vs. Transperitoneal (TP) approach was evaluated. The retroperitoneal approach for open surgical repair of abdominal aortic aneurysms provides excellent access and is associated with less post-operative morbidity compared to transperitoneal repair.
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