Key result
An optimized retroperitoneal approach for open aortic repair, involving partial removal of the tenth rib without incising the pleura and diaphragm, was successfully performed in three patients with no major postoperative complications.
Why the study?
Does an optimized retroperitoneal approach improve surgical exposure and avoid thoracotomy in patients with pararenal abdominal aortic aneurysm, abdominal aortic dissection, or renal artery aneurysm?
Case Report (n=3)
No
Does an optimized retroperitoneal approach improve surgical exposure and avoid thoracotomy in patients with pararenal abdominal aortic aneurysm, abdominal aortic dissection, or renal artery aneurysm?
An optimized retroperitoneal approach involving partial removal of the tenth rib allows for easy exposure of the suprarenal aorta without the need for thoracotomy during open aortic repair.
Answers are grounded in this paper and cite their sources.
Modified approach feasible in three suprarenal AAA cases; hypothesis-generating and requires prospective validation before clinical consideration.
The ninth intercostal thoracoretroperitoneal incision is the most common approach for open repair of suprarenal abdominal aortic aneurysm or abdominal aortic dissection, which necessitates incision of the pleura and diaphragm and may lead to cardiorespiratory distress postoperatively. We optimized this approach by partially removing the tenth rib, bluntly dissecting the diaphragm from its costal edge, and retracting the diaphragm superiorly. We successfully performed this approach in three patients with pararenal abdominal aortic aneurysm, abdominal aortic dissection, or renal artery aneurysm. Based on our experience, this approach allows easy exposure of the suprarenal aorta and avoids thoracotomy, which would potentially benefit patients' prognosis.
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Wang et al. (2016) conducted a case report in Suprarenal abdominal aortic aneurysm and dissection (n=3). Optimized retroperitoneal approach (partial removal of the tenth rib without incising pleura and diaphragm) was evaluated on Major postoperative complications (paraplegia, renal failure, or cardiorespiratory distress). An optimized retroperitoneal approach for open aortic repair, involving partial removal of the tenth rib without incising the pleura and diaphragm, was successfully performed in three patients with no major postoperative complications.
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