Journal «Angiology and Vascular Surgery» • 

2011 • VOLUME 17 • №1

OBJECTIVE CRITERIA FOR THE INVASIVE NATURE OF A MINI-APPROACH IN AORTOFEMORAL RECONSTRUCTIONS. A PROSPECTIVE STUDY

Maksimov A.V., Feiskhanov A.K., Plotnikov M.V.
Department of Vascular Surgery Republican Clinical Hospital under the Ministry of Public Health of the Republic of Tatarsta, Chair of Cardiology and Angiology, Kazan State Medical Academy of the Federal Agency for Public Health and Social Development»,
Kazan, Republic of Tatarstan, Russia

The authors carried out a prospective study of the invasive nature of aortofemoral reconstruction performed via the standard routine laparotomy (StLT, Group I, n 10) and minilaparotomy (MLT, Group II, n = 10).

It was determined that the objective criteria for the invasive degree of the intervention wеre less pronounced in the group of the patients operated on through the MLT, with the main differences manifesting themselves to a greater extent in the early postoperative period. Despite statistically significant differences of the creatinphosphokinase (CPK) level as a marker of a parietal injury (562 U/l in Group I, 243 U/l in Group II, P = 0.005), the concentration of Cortisol increased dramatically during the operation (by 288 and 162%, respectively) with a statistically insignificant deference between the groups (P = 0.08). Alterations in the vegetative status (determined by cardiointervalography ) in the intraoperative period were of a variously directed variable character, not differing between the groups. However, normalization of these parameters in the postoperative period occurred more rapidly in MLT. Group II patients were noted to restore earlier the function of the gastrointestinal trapt with a less pronounced pain syndrome tested by the visual analogue scale, especially on postoperative days 2 and 4 (p<0.01) …

Hence, reconstruction of the infrarenal aorta through the MLT is characterized by a lesser invasive nature, with the above mentioned differences being more pronounced in the early postoperative period, since the main intraoperative factors of the invasion depend to a lesser extent on the approach size.

KEY WORDS: mini-approach, atherosclerosis of the aortofemoral segment.

P. 130

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