title: A comparison of total laparoscopic and open repair of abdominal aortic aneurysms.
abstract: OBJECTIVE
  The feasibility of total laparoscopic abdominal aortic aneurysm (AAA) repair has been well established. In a previous case-control study, we showed that the postoperative courses of total laparoscopic and open AAA repairs were similar. The purpose of this study was to compare the long-term results of these techniques in the same cohort of patients.
  
  
  METHODS
  Thirty patients with AAAs treated by total laparoscopic repair between July 2003 and December 2004 (group I) were matched in a case-control fashion by morphology and American Society of Anesthesiologists class with 30 patients who underwent open AAA repair between April 1997 and May 2004 (group II). Patients who survived the intervention were followed up during 5 years. Follow-up consisted of physical examination and duplex ultrasonography at 1 month and yearly thereafter. Group I patients had an additional control computed tomography scan within the first 3 months postoperatively.
  
  
  RESULTS
  Five-year cumulative survival rates were similar (group I: 83% ± 7% vs group II: 79% ± 7%; log-rank test, P = .69). No late aneurysm-related death occurred during the follow-up period. Incisional hernias were more likely to occur in group II patients (group I: 0% vs group II: 15.4%; P = .047). Incidence of postoperative sexual dysfunction was similar in both groups (group I: 22.2% vs group II: 25.0%; P = not significant [NS]). No late reintervention was recorded in group I, whereas 2 patients in group II had incisional hernia repair. At 5 years, no graft sepsis or anastomotic pseudoaneurysm was reported.
  
  
  CONCLUSIONS
  This study suggests that total laparoscopic AAA repair provides good long-term results, comparable to those of open repair in terms of aneurysm-related mortality and morbidity. It may reduce the incidence of laparotomy-related complications.
authors.affiliation: Department of Vascular Surgery, Ambroise Paré Hospital and Faculté de Médecine Paris-Iles de France-Ouest, Université de Versailles-Saint Quentin-en-Yvelines, Boulognes-Billancourt, Hauts-De-Seines, France. cochennecf@gmail.com
authors.forename: Frédéric
authors.initials: F
authors.lastname: Cochennec
authors.forename: Isabelle
authors.initials: I
authors.lastname: Javerliat
authors.forename: Isabelle
authors.initials: I
authors.lastname: Di Centa
authors.forename: Olivier
authors.initials: O
authors.lastname: Goëau-Brissonnière
authors.forename: Marc
authors.initials: M
authors.lastname: Coggia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D005602:France; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex