title: Total laparoscopic aortobifemoral bypass: short- and middle-term results.
abstract: We describe early and mid-term results of total laparoscopic aortofemoral bypass (TLAFB). TLAFB was performed in 150 cases of severe aortoiliac occlusive disease. Aortic approaches included transperitoneal left retrocolic (n = 86), left retrorenal (n = 51), and direct (n = 4); the retroperitoneoscopic approach was used in nine cases. The procedure was totally laparoscopic in 145 patients (96.6%). Median operative and clamping times were 260 (120-450) and 81 (36-190) min, respectively. Thirty-day mortality was 2.7%. Nonlethal systemic, local vascular, and local nonvascular complications occurred in 21 (14.3%), seven (4.8%), and two (1.3%) patients, respectively. Median return to general diet and ambulation were, respectively, days 2 and 3. Median hospital stay was 7 days. Follow-up was 25.2 +/- 17.6 months (range 1-60) with 3-year primary and secondary actuarial patency rates of 93% and 95.6%, respectively. TLAFB gives early and mid-term patency rates comparable to open direct repair. Laparoscopy allows faster recovery and reduces operative trauma.
authors.affiliation: Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique Hôpitaux de Paris, Boulogne-Billancourt, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Di Centa
authors.forename: Marc
authors.initials: M
authors.lastname: Coggia
authors.forename: Pierre
authors.initials: P
authors.lastname: Cerceau
authors.forename: Isabelle
authors.initials: I
authors.lastname: Javerliat
authors.forename: Pascal
authors.initials: P
authors.lastname: Alfonsi
authors.forename: Alain
authors.initials: A
authors.lastname: Beauchet
authors.forename: Olivier
authors.initials: O
authors.lastname: Goëau-Brissonnière
mesh_terms: D001012:Aorta, Abdominal / Q000601:surgery*; D001018:Aortic Diseases / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D011183:Postoperative Complications; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods