title: Conversion during laparoscopic aortobifemoral bypass: a failure?
abstract: 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.
authors.affiliation: Department of Vascular Surgery, University Hospital Leuven, Leuven, Belgium. inge.fourneau@uzleuven.be
authors.forename: I
authors.initials: I
authors.lastname: Fourneau
authors.forename: I
authors.initials: I
authors.lastname: Mariën
authors.forename: Ph
authors.initials: P
authors.lastname: Remy
authors.forename: C
authors.initials: C
authors.lastname: D'hont
authors.forename: T
authors.initials: T
authors.lastname: Sabbe
authors.forename: K
authors.initials: K
authors.lastname: Daenens
authors.forename: S
authors.initials: S
authors.lastname: Houthoofd
authors.forename: A
authors.initials: A
authors.lastname: Nevelsteen
mesh_terms: 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