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Minimally invasive or conventional aorto-bifemoral by-pass. A randomised study
G de Donato1, G Weber, G de Donato
1San Giovanni Bosco Hospital, Angiosurgical Department, II University of Naples, Italy.
Introduction:
open transperitoneal aorto-bifemoral by-pass is still associated with a relatively high morbidity and mortality. To decrease this surgical stress, minimally invasive direct aortic surgery (MIDAS) was developed, utilizing a minilaparotomy and a retroperitoneal approach to the aorta.
Objectives:
to compare in a randomised controlled trial whether mortality and morbidity could be reduced with MIDAS.
Methods:
from October 1997 to September 2000, 300 patients were randomised to either MIDAS (n=150) or conventional aorto-bifemoral by-pass surgery (n=150).
Results:
the perioperative (30 days) mortality (2.6%), was equal in both groups. MIDAS were significantly reduced length of hospital stay (3.1 days), and pulmonary dysfunction.
Conclusions:
MIDAS reduced trauma and pain, which resulted in a shorter hospital stay, and a reduction in costs.