The extended retroperitoneal approach for treatment of extensive atherosclerosis of the aorta and renal vessels

G. Melville Williams, John Ricotta, Michael Zinner, James F. Burdick

Research output: Contribution to journalArticle

Abstract

The aorta was exposed by a standard "nephrectomy" incision through the eleventh interspace in 53 patients with aneurysmal or occlusive disease. The plane posterior to the kidney and uretex was developed easily, enabling exposure of the aorta above the level of the celiac axis to its bifurcation by dividing only the crus of the diaphragm and the lumbar branch of the left renal vein. Twenty-five patients with abdominal aortic aneurysms were treated in this fashion. In all but four there were significant risk factors, including extension of the aneurysm to or above the level of the renal arteries in eight and coexisting renal artery stenosis with hypertension in two. Twenty-eight patients with occlusive vascular disease were treated surgically. In eight, this was the second operation on the aorta while in 11, major occlusive disease involved the aorta as well as the renal/visceral arteries. The operative mortality rate was 8%. Eighty-nine percent of the patients were alive at this writing. Of 18 hypertensive patients, 9 were not taking medication and only 3 have not improved significantly. We recommend this approach for reoperations on the aorta and for patients who have extensive aneurysmal and/or occlusive disease of the aorta, renal, and visceral arteries.

Original languageEnglish (US)
Pages (from-to)846-855
Number of pages10
JournalSurgery
Volume88
Issue number6
StatePublished - 1980

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Aorta
Atherosclerosis
Kidney
Renal Artery
Therapeutics
Renal Artery Obstruction
Renal Veins
Abdominal Aortic Aneurysm
Diaphragm
Nephrectomy
Vascular Diseases
Reoperation
Abdomen
Aneurysm
Hypertension
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

The extended retroperitoneal approach for treatment of extensive atherosclerosis of the aorta and renal vessels. / Williams, G. Melville; Ricotta, John; Zinner, Michael; Burdick, James F.

In: Surgery, Vol. 88, No. 6, 1980, p. 846-855.

Research output: Contribution to journalArticle

Williams, G. Melville ; Ricotta, John ; Zinner, Michael ; Burdick, James F. / The extended retroperitoneal approach for treatment of extensive atherosclerosis of the aorta and renal vessels. In: Surgery. 1980 ; Vol. 88, No. 6. pp. 846-855.
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