ABSTRACT
Experience of resections of abdominal aortic aneurysms at 108 patients through mini-laparotomy is analyzed. The majority of patients were senior with severe concomitant diseases. Method of minimally-invasive resection of abdominal aortic aneurysms and special device (mini-assistant) are described in details.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Laparoscopy/methods , Minimally Invasive Surgical Procedures/methods , Aged , HumansABSTRACT
The authors compare various surgical strategies of infrarenal abdominal aorta aneurysm (IAAA) repair based on the experience of the Department of Cardiovascular Surgery, Urban Clinical Hospital No.81. Total 198 patients underwent aneurysm resection and grafting through conventional (90) or minilaparotomy (108) approaches. Mini-approach was shown to improve significantly both perioperative course and outcomes of IAAA correction. The main advantage of this approach comprised limited invasiveness together with sufficient exposure of abdominal aorta and its branches. Abandoning small bowel evisceration helps to preserve ther-moregulation and achieve volemic homeostasis with less fluid volume. Postoperative period after surgical mini-approach was characterized by shorter period of mechanical ventilation and ICU stay, earlier restoration of bowel motility, conversion to usual nutrition, patient mobilization and discharge. Minimally invasive technology significantly broadens feasibility of radical aortic reconstructions for patients with serious cardio-vascular comorbidities.
Subject(s)
Aortic Aneurysm, Abdominal/pathology , Aortic Aneurysm, Abdominal/surgery , Laparotomy/methods , Renal Artery/pathology , Renal Artery/surgery , Aged , Female , Humans , MaleABSTRACT
The experience with simultaneous operations in 16 patients with multifocal atherosclerosis and cholelithiasis is analyzed. The operations were performed simultaneously through two mini-approaches with original "mini-assistant" devices. Short- and long-term postoperative results are analyzed, indications and surgical techniques through mini-approach in elderly patients are reported.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Cholelithiasis/surgery , Coronary Artery Disease/surgery , Minimally Invasive Surgical Procedures/methods , Aged , Aortic Aneurysm, Abdominal/complications , Cholelithiasis/complications , Coronary Artery Disease/complications , Female , Humans , MaleABSTRACT
The experience with resection of abdominal aortic aneurysms in 72 patients through minilaparotomy is analyzed. Surgery was performed in elderly patients (mean age was 73.5+/-5.7 years) with severe concomitant diseases. The size of the aneurysms was large and middle in 64%, patients with small aneurysms had occlusive and stenotic lesions of the iliac segment with chronic lower limb ischemia of stage II and III. An original surgical method is proposed with use of special vascular instruments and a"mini-assistant" set. Simultaneous operations along with aneurysms resection were performed in 10 (13.8%) patients. Good results were achieved in 97.3% cases. The application of a mini-approach is limited by intra- and suprarenal locations of the aneurysm.