Treatment of infected abdominal aortic aneurysm with extra-anatomic bypass in retroperitoneum

Objective To study the clinical effect of retroperitoneal extra-anatomical bypass for the treatment of infectious abdominal aortic aneurysm. Methods The data of 4 cases of infectious abdominal aortic aneurysm treated by retroperitoneal bypass operation were analyzed retrospectively. Surgical procedures were performed as follows: A retroperitoneal tunnel was made to place the bifurcate vasculargraft, and three ends of the graft were separately led to abdominal aorta and to each external iliac arteries. The graft was anastomosed to abdominal aorta in end to end way,and to each external iliac arteries in end to side way. After closure of the posterior peritoneum, the aneurysm was excised and its inside was cleaned up, and the lumbar arteries and distal common iliac artery were sewed up(the reverse the blood flows from external to internal iliac arteries should be reserved as much as possible). The inside of the aneurysm was treated with hydrogen peroxide and dilute iodine, then drain tube was placed, omentum majus was rammedand stitched up. Except for1 case of emergency, antibiotics were used for about 4~6 weeks before and after the operation. Results There was no death case during the perioperative period. All patients discharged 3~5 weeks after operation. During a follow up of 0.5~5 years,no patient suffered from fever or abdominal pain. Conclusion Retroperitoneal extraanatomical bypass is an effective way to treat abdominal aortic aneurysm.