TRANSPERITONEAL VERSUS EXTRAPERITONEAL APPROACH FOR ROUTINE VASCULAR RECONSTRUCTION OF THE ABDOMINAL-AORTA

In this non-randomised retrospective study we have compared 79 cases w ith transperitoneal approach and 90 cases with extended postero-latera l extraperitoneal approach for elective reconstruction of the infraren al aorta. In the extraperitoneal group more patients were diabetic (7. 8% vs 1.3%, p < 0.05) or had a serum creatinin of more than 1.5 mg% (1 0.1% vs 2.5%, p < 0.05). The study shows that in spite of a higher pro portion of risk factors, a longer preparation (61' vs 44', p < 0.001), dissection (55' vs 46', p < 0.05) and total procedure time (193' vs 1 73', p < 0.05), the need for more blood transfusion (2.8 U vs 2.3 U, p < 0.05) and colloid perfusion (2.1 L vs 1.8 L, p < 0.05) in the extra peritoneal group, the incidence of complications is not higher compare d to the transperitoneal group (29% vs 24%, NS). On the contrary, prob lems of intestinal transit were found exclusively in the transperitone al group (7.6%, p < 0.0 1). Therefore it seems that, as far as the per i- and postoperative period is concerned the extraperitoneal approach might be the technique of choice for the simple elective infrarenal ao rta reconstructions.