Journal «Angiology and Vascular Surgery» • 

1998 • VOLUME 4 • №2

RECOVERY AFTER AORTO-ILIAC RECONSTRUCTIONS. CONVENTIONAL TRANSPERITONEAL VERSUS RETROPERITONEAL VIDEO-ASSISTED SURGERY

R. Kolvenbach, S. Wassiljew
Department of Vascular Surgery Augusta Hospital,
Duesseldorf, Germany

Previous studies have shown that laparoscopic assisted procedures can be applied in aorta-iliac reconstructive surgery. We wanted to evaluate whether patients after video-assisted surgery would recover sooner and could be discharged earlier from the hospital compared to patients operated in a conventional way using a standardmidline incision. The patient cohort comprised 30 patients operated for occlusive aorta-iliac disease. Among these were 15 patients operated using a videoassisted gasless technique and a retroperitoneal access. The abdominal wall was elevated with the help of a wall lifting device. Suturing of the anastomosis was performed using conventional vascular surgical instruments. During the same period of time 15 patients were operated in a conventional transperitoneal way and served as a reference group. All data were analyzed retrospectively. In the conventional group there were 9 aortofemoral bypass procedures and 6 thrombendarterectomies versus 11 aorta-femoral grafts and 4 endarterectomies in the laparoscopically assisted group. The mean operative time and mean crossclamp time were longer in the minimal invasive group though not significantly. ICU and mean postoperative hospital stay were significantly shorter in the laparoscopically assisted group (p<0.001 and p<0.021). The total amount of morphine given was reduced in the minimal invasive group (p<0.08) and the last parenteral narcotic was given earlier during the postoperative course (p<0.02). Parenteral nutrition was required over a longer period of time in patients with a transperitoneal approach (p<0.0l5) and oral feeding could be resumed earlier in the study group (p<0.002). Respiratory function (FEVI and FVC) was significantly compromised in the transperitoneally operated patients (p<0.03 and p<0.05).

P. 71-81

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