低侵襲な腹部動脈手術 : 腹膜外到達法による小切開手術

概要

論文の詳細を見る
We report two successful cases of minimal incision retroperitoneal approach in aortoiliac surgery. Case 1: A 73-year-old man with infrarenal aortic aneurysm 5.5cm in diameter underwent aneurysm repair through a 10-cm incision in the right flank. To facilitate vascular anastomosis, any clamps were eliminated from the limited incision; the aorta was cross-clamped through a stab in the flank and the distal arteries were interrupted with small bulldog clamps. Operating time was 2 and half hours. He had a diet from the second day and tended to feel less pain after the surgery. Case 2: A 47-year-old man with right external iliac occlusion underwent iliofemoral bypass grafting through a 7-cm incision in the flank and a 2.5-cm incision in the groin. The abdominal muscles were not divided, simply split in layers. A silicone rubber retractor provided a satisfactory surgical space regardless of the limited incision. Vascular anastomosis was safe and smooth with the special technique as used in case 1. Operating time was 2 and quarter hours. The postoperative course was similar to that of case 1. Minimal incision retroperitoneal approach is less invasive than minimal laparotomy because of absence of bowel paralysis. It is safe and useful to reduce early and later wound troubles including pain, paresthesia, incisional hernia and muscle atrophy.
新潟大学の論文
2005-06-10