Application of extra-anatomic prosthesis bypass in the retroperitoneum for the treatment of infected abdominal aortic aneurysms

Abstract

Objective To assess the effectiveness of extra-anatomic prosthesis bypass in the retroperitoneum as a treatment for infected abdominal aortic aneurysms (iAAAs). Methods We retrospectively reviewed the records of 10 consecutive patients diagnosed with iAAAs and treated by an extra-anatomic prosthesis bypass in the retroperitoneum over the past 7 years. All 10 patients were regularly followed up by outpatient observation after their discharge. Results Ten patients with iAAAs underwent an extra-anatomic prosthesis bypass in the retroperitoneum and debridement of the infected aneurysm. An emergency operation was performed for one patient who underwent concomitant gastrointestinal procedures for aortoduodenal fistula, the other 9 cases underwent an elective operation after an intravenous antibiotic therapy for 2–4 weeks. All 10 patients were definitely diagnosed by one or more sequential CT scans combining with other methods. All patients had at least a positive preoperative blood culture or intraoperative tissue culture during the perioperative period, including Salmonella in 5 cases, Burkholderia pseudomallei in 3 cases, Escherichia coli in 1 case, Klebsiella pneumoniae in 1 case. All patients were discharged in 4-6 weeks after their operations. Except 1 case who died 16 months after surgery, all other patients were alive and were free from graft infection during the follow-up period. Conclusions The extra-anatomic prosthesis bypass in the retroperitoneum for treating iAAAs are safe and effective. Key words: Aortic aneurysm; Aorta, abdominal; Extra-anatomic bypass; Retroperitoneum; Prosthesis