Author/Editor     Klokočovnik, Tomislav; Špan, Matjaž
Title     Operacija anevrizme trebušne aorte skozi minilaparotomijo - uvodni rezultati
Translated title     Abdominal aortic surgery through minilaparotomy - initial results
Type     članek
Source     Med Razgl
Vol. and No.     Letnik 42, št. Suppl 2
Publication year     2003
Volume     str. 65-7
Language     slo
Abstract     Median laparotomy approach is the gold standard for endoaneurysmoraphy of abdominal aortic aneurysms. Minilaparotomy, a recently introduced technique, allows a visualization of the operative field that is comparable to that in median laparotomy, but significantly reduces surgical tissue damage. From June 1999 to February 2003, 76 patients with abdominal aortic aneurysm were operated via minilaparotomy. Endoaneurysmoraphy was performed through 8-10 cm long paraumbilical transperitoneal incisions. Minilaparotomy was contraindicated in patients with aneurysms larger than 10 cm in diameter, after previous abdominal surgery, and in obese patients. In 3 patients minilaparotomy had to be enlarged because of bleeding. In 2 cases, the surgical wound became inflamed and there was 1 case of perioperative death. Abdominal aortic surgery through minilaparotomy is safe, effective and esthetically more acceptable than the golden standard, median laparotomy. Endoscopic abdominal aortic surgery is not yet fully established and our results suggest that minilaparotomy has certain advantages that will need to be confirmed by further studies.
Summary     Pristop skozi mediano laparotomijo je zlati standard za endoanevrizmorafijo anevrizme trebušne aorte. Minilaparotomija, ki se je uveljavila v zadnjih letih, zagotavlja podobno vidljivost operacijskega polja kot mediana laparotomija in pomembno zmanjša kirurško poškodbo tkiv. Od junija 1999 do konca februarja 2003 smo operirali 76 bolnikov z anevrizmo trebušne aorte skozi minilaparotomijo. Endoanevrizmorafijo smo napravili skozi 8-10 cm dolgo paraumbilikalno transperitonealno incizijo. Kontraindikacije za operacijo so bile anevrizme, večje od 10 cm v premeru, predhodna operacija trebuha in debelost. Pri treh bolnikih smo morali minilaparotomijo povečati zaradi krvavitve. Opazili smo dve vnetji rane in en smrtni izid operacije. Za bolnike je ta metoda operiranja varna, učinkovita in estetsko sprejemljivejša od zlatega standarda. Endoskopske operacije trebušne aorte so še v začetnih fazah, zato se zdi, da ima minilaparotomija nekaj prednosti, ki pa jih je treba v prihodnje še potrditi.
Descriptors     AORTIC ANEURYSM, ABDOMINAL
LAPAROTOMY
SURGERY, MINIMALLY INVASIVE