Minimal Incision Surgery for the Aortoiliac Segment – Results of a Single-Center Study

Abstract

The purpose of this prospective single-center study was to determine the feasibility of minilaparotomy for aortoiliac segment and its effect on intraoperative and postoperative outcomes. Materials and Methods: From August 2020 to July 2022, the authors used minilaparotomy in 24 patients with aortoiliac atherosclerotic occlusive disease. The comparison group included 27 patients undergoing laparotomy. The age of the patients ranged from 58 to 83 years, among them 37 men and 14 women. In the group with traditional access, 9 aorto-bifurcational and 18 linear operations were performed; in the minimal incision group, there were 7 bifurcational and 17 linear interventions. Results and Discussion: The duration of surgery was 196.5±26.7 minutes for operations with traditional access, and 146.3±16.7 minutes in the group with minimal incision. On average, minimal incision surgeries were shorter by 52.3±14.4 minutes (p≤0.05). For patients from the group with minimal incision, the length of stay in intensive care was 1.27±0.4 days, and with traditional access 2.3±0.3 (p≤0.05). Postoperative bed stay for the group with mini-access was 6.4±0.5 days, for patients with classic access 9.2±1.2 days (p≤0.05). 4 patients in the comparison group had postoperative paresis, and in one of them it was complicated by eventration. In the long-term postoperative period, two patients in the comparison group required surgery for an incisional hernia. Conclusions: Minimal incision access to the aorta can reduce surgical trauma and intervention time, shorten the patient’s stay in the intensive care unit and postoperative bed, and minimize perioperative and postoperative complications. During repeated reconstructive interventions on the aorta, a “high” mini-access to the aorta allows to quickly reach the optimal area of the aorta for anastomosis and minimize organ trauma, as well as prevent adhesions in the abdominal cavity.