{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T05:42:53Z","timestamp":1769838173685,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,1,9]],"date-time":"2014-01-09T00:00:00Z","timestamp":1389225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aims to evaluate the contemporary outcome of left open retroperitoneal (<jats:styled-content style=\"fixed-case\">RP<\/jats:styled-content>) abdominal aortic surgery over a 7\u2010year time period in patients with difficult anatomy unsuitable for endovascular aneurysm repair (<jats:styled-content style=\"fixed-case\">EVAR<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty\u2010four consecutive patients unsuitable for <jats:styled-content style=\"fixed-case\">EVAR<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">FEVAR<\/jats:styled-content> underwent left <jats:styled-content style=\"fixed-case\">RP<\/jats:styled-content> open aortic surgery. Of these, 44 (52%) required an infrarenal cross\u2010clamp, 17 (20%) a suprarenal cross\u2010clamp and 15 (18%) a supracoeliac cross\u2010clamp. Eight (10%) were thoracoabdominal aneurysms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were four mortalities within 30 days (4.8%). Two occurred in patients with a supracoeliac cross\u2010clamp, one in a suprarenal cross\u2010clamp (total suprarenal mortality 10%) and one in an infrarenal cross\u2010clamp. Four patients required prolonged ventilatory support (&gt;10 days). Three patients (9%) from the suprarenal group developed post\u2010operative renal dysfunction, one of these required permanent dialysis. Paralytic ileus occured in two patients (2%) and was secondary to ischaemia in both cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There will always remain a small group of patients best treated by open aortic surgery. By definition, these are complex, difficult cases and are decreasing in number. However, in vascular units regularly performing the RP approach, excellent results can be obtained. This series provides further evidence for centralization of vascular services.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.12400","type":"journal-article","created":{"date-parts":[[2014,1,10]],"date-time":"2014-01-10T01:24:23Z","timestamp":1389317063000},"page":"861-865","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Left retroperitoneal aortic aneurysm repair in patients unsuitable for endovascular treatment"],"prefix":"10.1111","volume":"84","author":[{"given":"Christopher P.","family":"Twine","sequence":"first","affiliation":[{"name":"Cardiff Regional Vascular Unit University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Von\u2010Oppell","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian M.","family":"Williams","sequence":"additional","affiliation":[{"name":"Cardiff Regional Vascular Unit University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,1,9]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7811"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7804"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.04.021"},{"key":"e_1_2_5_5_1","first-page":"846","article-title":"The extended retroperitoneal approach for treatment of extensive atherosclerosis of the aorta and renal vessels","volume":"88","author":"Williams GM","year":"1980","journal-title":"Surgery"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2013.03.018"},{"key":"e_1_2_5_7_1","first-page":"87","article-title":"Extraperitoneal approach to the abdominal aorta","volume":"53","author":"Rob C","year":"1963","journal-title":"Surgery"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(03)00441-5"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6848"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0064163"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2009.07.002"},{"key":"e_1_2_5_12_1","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/0741-5214(91)90078-9","article-title":"Left flank retroperitoneal exposure: a technical aid to complex aortic reconstruction","volume":"14","author":"Shepard AD","year":"1991","journal-title":"J. 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