Key result
Transperitoneal, retroperitoneal, and endovascular approaches show no difference in peri-operative mortality for elective AAA repair.
Why the study?
Does the surgical approach (transperitoneal, retroperitoneal, or endovascular) affect peri-operative mortality and morbidity in patients undergoing elective infrarenal AAA repair?
Cohort (n=210)
Does the surgical approach (transperitoneal, retroperitoneal, or endovascular) affect peri-operative mortality and morbidity in patients undergoing elective infrarenal AAA repair?
p-value: p=n.s.
In specialized centers, elective infrarenal AAA repair has low peri-operative mortality regardless of whether a transperitoneal, retroperitoneal, or endovascular approach is used.
We retrospectively analyzed the peri-operative outcome of 210 consecutive patients undergoing elective infrarenal abdominal aortic aneurysm (AAA) repair according to the surgical approach: transperitoneal (TP; 63 patients), retroperitoneal (RP; 81 patients) and endovascular (EV; 66 patients) repair. Concerning gender, AAA diameter and classification of the American Society of Anesthesiologists (ASA score) all groups were comparable; the median age in the EV group was significantly higher (78 years vs. 68 years and 67 years, respectively, P=0.001). Mortality rates were 0% for TP, 1.2% for RP and 3% for EV repair (n.s.). Morbidity rates did not significantly differ between the groups. In specialized centres mortality rates of elective infrarenal aneurysm repair are low - regardless of the surgical approach. In such centres the best treatment options for each patient as to the surgical approach as well as peri-operative management can be provided individually.
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Muehling et al. (2009) conducted a cohort in elective infrarenal abdominal aortic aneurysm (AAA) (n=210). Surgical approach (transperitoneal, retroperitoneal, endovascular) was evaluated on Peri-operative mortality (p=n.s.). Peri-operative mortality for elective infrarenal AAA repair did not significantly differ between transperitoneal (0%), retroperitoneal (1.2%), and endovascular (3%) approaches.
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