title: Laparoscopic versus open approach for aortobifemoral bypass for severe aorto-iliac occlusive disease--a multicentre randomised controlled trial.
abstract: OBJECTIVE
  To investigate differences between open and laparoscopic aortobifemoral bypass surgery for aorto-iliac occlusive disease on postoperative morbidity and mortality.
  
  
  METHODS
  A multicentre randomised controlled trial.
  
  
  METHODS
  Between January 2007 and November 2009, 28 patients with severe aorto-iliac occlusive disease (TASC II C or D) were randomised between laparoscopic and open approach at one community hospital and one university hospital (TASC = Trans-Atlantic Inter-Society Consensus on the Management of Peripheral Arterial Disease).
  
  
  RESULTS
  The operation time was longer for the laparoscopic approach (mean 4 h 19 min (2 h 00 min to 6 h 20 min) vs. 3 h 30 min (1 h 42 min to 5 h 11 min); p = 0.101)). Nevertheless, postoperative recovery and in-hospital stay were significantly shorter after laparoscopic surgery. Also oral intake could be restarted earlier (mean 20 h 34 min (6 h 00 min to 26 h 55 min) vs. 43 h 43 min (19 h 40 min to 77 h 30 min); p = 0.00014)) as well as postoperative mobilisation (walking) (mean 46 h 15 min (16 h 07 min to 112 h 40 min) vs. mean 94 h 14 min (66 h 10 min to 127 h 23 min); p = 0.00016)). Length of hospitalisation was shorter (mean 5.5 days (2.5-15) vs. mean 13.0 days (7-45); p = 0.0095)). Visual pain scores and visual discomfort scores were both lower after laparoscopic surgery. Also return to normal daily activities was achieved earlier. There were no major complications in both groups.
  
  
  CONCLUSIONS
  Laparoscopic aortobifemoral bypass surgery for aorto-iliac occlusive disease is a safe procedure with a significant decrease in postoperative morbidity and in-hospital stay and earlier recovery.
authors.affiliation: Department of Vascular Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Tiek
authors.forename: P
authors.initials: P
authors.lastname: Remy
authors.forename: T
authors.initials: T
authors.lastname: Sabbe
authors.forename: C
authors.initials: C
authors.lastname: D'hont
authors.forename: S
authors.initials: S
authors.lastname: Houthoofd
authors.forename: K
authors.initials: K
authors.lastname: Daenens
authors.forename: I
authors.initials: I
authors.lastname: Fourneau
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001018:Aortic Diseases / Q000401:mortality / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000601:surgery*; D001530:Belgium; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D003251:Constriction, Pathologic; D005260:Female; D006764:Hospitals, Community; D006785:Hospitals, University; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D020127:Recovery of Function; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome