Metcalf R K, Rutherford R B
Department of Surgery, University of Colorado Health Sciences Center, Denver.
Surgery. 1991 Apr;109(4):555-7.
In three recent cases, one of which is described in this report, we have found the retroperitoneal approach to have the following significant and distinct advantages over the transabdominal repair of inflammatory abdominal aortic aneurysms: (1) The posterolateral aspect of the aorta characteristically is not significantly involved by the inflammatory process, whereas the anterior aspect is. (2) The duodenum does not need to be dissected away from the aorta and, in fact, is not seen. (3) The left renal vein moves up off the neck of the aneurysm with forward mobilization of the kidney, facilitating proximal control. Now that the computerized tomography scan has become the preferred preoperative imaging technique for abdominal aortic aneurysms, the diagnosis of inflammatory abdominal aortic aneurysm can routinely be made before elective operation allowing the retroperitoneal approach to be selected.
在最近的三例病例中（其中一例在本报告中描述），我们发现与经腹修复炎性腹主动脉瘤相比，腹膜后入路具有以下显著且独特的优势：（1）主动脉的后外侧通常未被炎症过程显著累及，而前侧则不然。（2）十二指肠无需从主动脉分离，实际上也看不到。（3）随着肾脏向前游离，左肾静脉从动脉瘤颈部向上移位，便于近端控制。既然计算机断层扫描已成为腹主动脉瘤首选的术前成像技术，炎性腹主动脉瘤通常可在择期手术前作出诊断，从而能够选择腹膜后入路。
