Hand-assisted laparoscopy versus conventional median laparotomy for aortobifemoral bypass for severe aorto-iliac occlusive disease: a prospective randomised study.
OBJECTIVE
To demonstrate that hand-assisted laparoscopy for aortofemoral bypass for severe aorto-iliac occlusive disease reduces morbidity with earlier recovery of bowel function and shorter in-hospital stay.


METHODS
Randomised controlled trial.


METHODS
Thirty-six consecutive patients with severe aorto-iliac occlusive disease (TASK C/D) without history of major abdominal surgery necessitating an aortobifemoral bypass were randomised between a hand-assisted laparoscopic (HALS) approach and a conventional medial laparotomy. Operative data, early recovery data, quality of life and vascular outcome were analysed.


RESULTS
No significant differences in operative data were found. Fluid and solid diet were resumed earlier (28.8 hrs vs. 76.9 hrs; p = 0.016) (45.6 hrs vs. 105.6 hrs; p = 0.02) and in-hospital stay was shorter (7.5 vs. 8.9 days; p = 0.005) in the HALS group. Six weeks post-operatively social functioning measured by the SF-36 survey score was better in patients randomised to HALS (p=0.023).


CONCLUSIONS
HALS is a less invasive approach for aortofemoral bypass.
Fourneau
I
I
Department of Vascular Surgery, University Hospital Gasthuisberg, Leuven, Belgium. Inge.Fourneau@uz.kuleuven.ac.be
Sabbe
T
T
Daenens
K
K
Nevelsteen
A
A
D000328:Adult; D000368:Aged; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D016063:Blood Loss, Surgical; D001831:Body Temperature; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012107:Research Design; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods