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

Area of Science:

• Vascular Surgery
• Minimally Invasive Surgery

Background:

• Aortic surgery, particularly for aortoiliac occlusive disease, can impose significant surgical stress.
• Conventional surgical approaches often involve extensive incisions and longer recovery periods.

Purpose of the Study:

• To evaluate the efficacy and patient outcomes of a less extensive surgical procedure using minilaparotomy and videoendoscopy compared to conventional surgery for aortoiliac occlusive disease.

Main Methods:

• A randomized trial comparing minilaparotomy (ML) with conventional approach (CA) for aortoiliac occlusive disease.
• Sixty-two patients were randomized; 37 in the ML group and 25 in the CA group.
• Outcomes assessed included intraoperative complications, postoperative recovery, pulmonary function, and long-term survival.

Main Results:

• The minilaparotomy group showed significantly shorter nasogastric drainage, earlier bowel movement, and initiation of alimentation.
• Postoperative pulmonary function decline was less severe in the ML group.
• The ML group experienced significantly shorter intensive care unit and overall hospital stays, required less analgesia, and reported higher overall satisfaction.

Conclusions:

• Minilaparotomy combined with videoendoscopy is a less extensive and effective surgical option for aortoiliac occlusive disease.
• This approach reduces surgical stress, leading to improved postoperative recovery and patient satisfaction.
• Long-term survival rates were comparable between the minilaparotomy and conventional approach groups.