Retroperitoneal Repair of Abdominal Aortic Aneurysm Reduces Bowel Dysfunction

N. Arya, M.A. Sharif, L.L. Lau, B. Lee, R.J. Hannon, Ian Young, C.V. Soong

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: To assess the effect of intestinal manipulation and mesenteric traction on gastro-intestinal function and postoperative recovery in patients undergoing abdominal aortic aneurysm (AAA) repair. Methods: Thirty-five patients undergoing AAA repair were randomised into 3 groups. Group I (n = II) had repair via retroperitoneal approach while Group II (n = 12) and Group III (n = 12) were repaired via transperitoneal approach with bowel packed within the peritoneal cavity or exteriorised in a bowel bag respectively. Gastric emptying was measured pre-operatively (day 0), day 1 and day 3 using paracetamol absorption test (PAT) and area under curve (P-AUC) was calculated. Intestinal permeability was measured using the Lactulose-Mannitol test. Results: Aneurysm size, operation time and PAT (on day 0 and day 3) were similar in the three groups. On day 1, the P-AUC was significantly higher in Group I, when compared with Group II and Group III (P = .02). Resumption of diet was also significantly earlier in Group I as compared to Group II and Group III. The intestinal permeability was significantly increased in Group II and Group III at day 1 when compared with day 0, with no significant increase in Group I. Retroperitoneal repair was also associated with significantly shorter intensive care unit (P = .04) and hospital stay (P = .047), when compared with the combined transperitoneal repair group (Group II and III). Conclusion: Retroperitoneal AAA repair minimises intestinal dysfunction and may lead to quicker patient recovery when compared to transperitoneal repair.
Original languageEnglish
Pages (from-to)262-270
Number of pages9
JournalVascular and Endovascular Surgery
Volume43
Issue number3
DOIs
Publication statusPublished - Jun 2009

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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