title: Minimally invasive or conventional aorto-bifemoral by-pass. A randomised study.
abstract: BACKGROUND
  open transperitoneal aorto-bifemoral by-pass is still associated with a relatively high morbidity and mortality. To decrease this surgical stress, minimally invasive direct aortic surgery (MIDAS) was developed, utilizing a minilaparotomy and a retroperitoneal approach to the aorta.
  
  
  OBJECTIVE
  to compare in a randomised controlled trial whether mortality and morbidity could be reduced with MIDAS.
  
  
  METHODS
  from October 1997 to September 2000, 300 patients were randomised to either MIDAS (n=150) or conventional aorto-bifemoral by-pass surgery (n=150).
  
  
  RESULTS
  the perioperative (30 days) mortality (2.6%), was equal in both groups. MIDAS were significantly reduced length of hospital stay (3.1 days), and pulmonary dysfunction.
  
  
  CONCLUSIONS
  MIDAS reduced trauma and pain, which resulted in a shorter hospital stay, and a reduction in costs.
authors.affiliation: San Giovanni Bosco Hospital, Angiosurgical Department, II University of Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: de Donato
authors.forename: G
authors.initials: G
authors.lastname: Weber
authors.forename: G
authors.initials: G
authors.lastname: de Donato
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D010529:Peritoneal Cavity / Q000601:surgery*; D011446:Prospective Studies; D015996:Survival Rate; D014656:Vascular Surgical Procedures