Conversion during laparoscopic aortobifemoral bypass: a failure?
OBJECTIVE
To study the impact of conversion on postoperative recovery, morbidity and mortality in laparoscopic aortobifemoral bypass surgery for aorto-iliac occlusive disease (AIOD).


METHODS
Retrospective analysis of a prospectively maintained database.


METHODS
Between November 2002 and December 2006, 139 patients were treated for severe AIOD with a laparoscopic aortobifemoral bypass at one community and one university hospital. Demographic data, operative data, postoperative recovery data, morbidity and mortality were recorded and analysed according to a conversion and a non-conversion group.


RESULTS
Conversion was needed in 13.7% of the patients. Morbidity was 16.5%-14.2% in the non-conversion group and 31.8% in the conversion group. Systemic morbidity was significantly higher in the conversion group (31.6% vs.10%; p=0.002), but only one patient had incomplete recovery; local morbidity was comparable in both groups (10.5% vs. 5.8%; p=0.337). Mortality rate was 2.2%.


CONCLUSIONS
Laparoscopic aortobifemoral bypass surgery is a safe procedure for the treatment of AIOD. The outcome of patients after conversion is not affected in the way that it could be an impediment to start a laparoscopic procedure. Conversion in time is a safe way to overcome the learning curve.
Fourneau
I
I
Department of Vascular Surgery, University Hospital Leuven, Leuven, Belgium. inge.fourneau@uzleuven.be
Mariën
I
I
Remy
Ph
P
D'hont
C
C
Sabbe
T
T
Daenens
K
K
Houthoofd
S
S
Nevelsteen
A
A
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001530:Belgium / Q000453:epidemiology; D016009:Chi-Square Distribution; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D017211:Treatment Failure