Retroperitoneal repair of abdominal aortic aneurysms offers postoperative benefits to male patients in the veterans affairs health system

Matthew J. Borkon, Victor Zaydfudim, Christopher D. Carey, Colleen M. Brophy, Raul J. Guzman, Jeffery Dattilo

    Research output: Contribution to journalArticle

    7 Citations (Scopus)

    Abstract

    Background: Transperitoneal (TP) and retroperitoneal (RP) approaches have equal efficacy in elective open abdominal aortic aneurysm (AAA) repair. The effect of open operative approach on patient-specific outcomes after AAA repair was tested. Methods: Consecutive patients undergoing open AAA repair at the Veterans Affairs Tennessee Valley Healthcare System between January 2000 and August 2008 were retrospectively reviewed. Analysis was performed to examine the effects of demographic and clinical covariates on postoperative outcomes. Results: A total of 106 patients were identified: 54 with TP approach and 52 with RP approach. Demographics and preoperative comorbidities were equivalent (p ≥ 0.10), with the exception of chronic obstructive pulmonary disease which was more prevalent in the TP group (61 vs. 40%). Operative times were longer in the TP group (4.6 vs. 3.5 hours; p < 0.01); however, significantly more TP patients had reconstruction with a bifurcated graft (72 vs. 2%; p < 0.01). Postoperative nasogastric tube decompression times were shorter in the RP group (1 vs. 3 days; p < 0.01), and RP approach led to a quicker return to preoperative diet (4 vs. 6 days; p = 0.05). Patients undergoing RP repair developed fewer incisional hernias (2 vs. 15%; p = 0.03). Conclusion: RP approach to AAA repair offers patients faster return of bowel function and is associated with fewer incisional hernias.

    Original languageEnglish (US)
    Pages (from-to)728-732
    Number of pages5
    JournalAnnals of Vascular Surgery
    Volume24
    Issue number6
    DOIs
    StatePublished - May 14 2010

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    Veterans Health
    Abdominal Aortic Aneurysm
    Demography
    Veterans
    Operative Time
    Decompression
    Chronic Obstructive Pulmonary Disease
    Comorbidity
    Diet
    Delivery of Health Care
    Transplants

    All Science Journal Classification (ASJC) codes

    • Surgery
    • Cardiology and Cardiovascular Medicine

    Cite this

    Retroperitoneal repair of abdominal aortic aneurysms offers postoperative benefits to male patients in the veterans affairs health system. / Borkon, Matthew J.; Zaydfudim, Victor; Carey, Christopher D.; Brophy, Colleen M.; Guzman, Raul J.; Dattilo, Jeffery.

    In: Annals of Vascular Surgery, Vol. 24, No. 6, 14.05.2010, p. 728-732.

    Research output: Contribution to journalArticle

    Borkon, Matthew J. ; Zaydfudim, Victor ; Carey, Christopher D. ; Brophy, Colleen M. ; Guzman, Raul J. ; Dattilo, Jeffery. / Retroperitoneal repair of abdominal aortic aneurysms offers postoperative benefits to male patients in the veterans affairs health system. In: Annals of Vascular Surgery. 2010 ; Vol. 24, No. 6. pp. 728-732.
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    abstract = "Background: Transperitoneal (TP) and retroperitoneal (RP) approaches have equal efficacy in elective open abdominal aortic aneurysm (AAA) repair. The effect of open operative approach on patient-specific outcomes after AAA repair was tested. Methods: Consecutive patients undergoing open AAA repair at the Veterans Affairs Tennessee Valley Healthcare System between January 2000 and August 2008 were retrospectively reviewed. Analysis was performed to examine the effects of demographic and clinical covariates on postoperative outcomes. Results: A total of 106 patients were identified: 54 with TP approach and 52 with RP approach. Demographics and preoperative comorbidities were equivalent (p ≥ 0.10), with the exception of chronic obstructive pulmonary disease which was more prevalent in the TP group (61 vs. 40{\%}). Operative times were longer in the TP group (4.6 vs. 3.5 hours; p < 0.01); however, significantly more TP patients had reconstruction with a bifurcated graft (72 vs. 2{\%}; p < 0.01). Postoperative nasogastric tube decompression times were shorter in the RP group (1 vs. 3 days; p < 0.01), and RP approach led to a quicker return to preoperative diet (4 vs. 6 days; p = 0.05). Patients undergoing RP repair developed fewer incisional hernias (2 vs. 15{\%}; p = 0.03). Conclusion: RP approach to AAA repair offers patients faster return of bowel function and is associated with fewer incisional hernias.",
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