Existen ventajas en el abordaje extraperitoneal para el tratamiento del aneurisma de aorta abdominal?

there are current controversies over the benefits of the extraperitoneal vs the transperitoneal approach for repairing an infrarenal abdominal aortic aneurysm. several studies report a reduction in morbidity and mortality with the former approach. this study reports the short term results using both approaches at one reference center. this is a 12 year, retrospective descriptive study of 299 patients who underwent an elective open repair of an abdominal aortic aneurysm, distributed in two groups: transperitoneal approach group=1, extraperitoneal approach group=2. a total of 93 patients in group 1 and 206 in group 2 were intervened, mainly male patients with an median age of 68 years. the frequencies of co-morbidities were similar in both groups. there was a reduced tendency of reoperations in group 2 (12.9%vs 5.8%), and a greater tendency of postoperative complications in group 1 (30.1% vs 12.6%). however, the types complications were similar. the results show a median hospital stay of 13.3 days (sd+- 10,4) vs. 7.19 days (sd+- 4.20) p=0.00001, median post-operative stay of 9.16 days (sd-+ 8,1) vs. 5.62 days (sd+- 3,46) p= 0.001 and median intensive unit stay of 2.76 days (sd+-4.19) vs 1.56 days (sd+-1.86) p=0.00001 in group 1 y 2 respectively. early global mortality was 3.3% with a distribution frequency of 6.5% (n=6) in group 1 and 1.9% (n=4) in group 2. in our experience, the extraperitoneal approach offers better results regarding hospital, postoperative and intensive care unit stay, as well as post-operative re-operation rates and complications. because of the small sample size, the mortality difference was not statistically significant; however, we found an important tendency towards improved mortality rates with this approach.