A randomized comparison between minilaparotomy and conventional approach for aortoiliac reconstructive surgery

To decrease the surgical stress on patients undergoing aortic surgery the authors developed a less extensive procedure utilizing minilaparotomy and videoendoscopy. From June 1993 through July 1996, patients undergoing surgery for aortoiliac occlusive disease were randomized comparing the minilaparotomy (ML) with conventional approach (CA). Sixty-two patients participated in this trial, with 37 in the ML group and 25 in CA group. There were no significant differences between the groups in terms of age, sex or comorbid conditions. The incidence of intraoperative complications was similar for both groups. After surgery, nasogastric drainage was significantly (p = 0.01) shorter, bowel movement and initiation of alimentation began earlier in ML group. Both groups of patients showed a significant decrease in vital capacity and forced exspiration volume postoperatively, but this depression was significantly higher (p = 0.05) in CA group. The ML group also had significantly shorter stay in the intensive care unit (p = 0.001) and the mean duration of the postoperative hospital stay was also significantly less (p = 0.05). Generally, the patients operated by ML method during the postoperative recovery period required less analgesia, and expressed better "overall satisfaction". In long-term follow-up (mean 21 months), there was no significant difference in survival rates between two groups.