Ip M W, Diaz C, LeVeen H H
Am J Surg. 1978 Aug;136(2):225-7. doi: 10.1016/0002-9610(78)90233-7.
An extraperitoneal approach for aortofemoral bypass has proven superior to the transperitoneal approach. The incision starts at the tip of the eleventh rib and extends obliquely downward to 2 inches above the femoral point, where it turns further downward over the femoral artery. This approach is especially suitable for a reversed L-shaped prosthesis which extends from the aorta directly to the left femoral artery and crosses the abdomen subcutaneously to the right groin, where an anastomosis is made with the right femoral artery. The operation is simple and rapid. Morbidity is reduced and recovery is accelerated. The same incision is used to perform aortoiliac endarterectomy. Fifteen patients with occlusive disease and twenty-one with aneurysms received reversed L-shaped prosthesis through an extraperitoneal approach. The procedure was superior to that involving a transperitoneal approach to the aorta and the reversed L-shaped graft was superior to the Y graft for replacement fo the iliac arteries.
腹主动脉-股动脉旁路移植术的腹膜外入路已被证明优于经腹入路。切口始于第十一肋尖，斜向下延伸至股动脉点上方2英寸处，然后在股动脉上方进一步向下转折。这种入路特别适合于反向L形假体，该假体从主动脉直接延伸至左股动脉，并经皮下穿过腹部至右腹股沟，在那里与右股动脉进行吻合。手术简单快捷。发病率降低，恢复加快。相同的切口用于进行腹主动脉-髂动脉内膜切除术。15例闭塞性疾病患者和21例动脉瘤患者通过腹膜外入路接受了反向L形假体。该手术方法优于经腹主动脉入路，且反向L形移植物在髂动脉置换方面优于Y形移植物。
