Laparoscopic aortic surgery: Techniques and results.

Détails

ID Serval
serval:BIB_984BF753D21E
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Laparoscopic aortic surgery: Techniques and results.
Périodique
Journal of Vascular Surgery
Auteur(s)
Cau J., Ricco J.B., Corpataux J.M.
ISSN
1097-6809[electronic]
Statut éditorial
Publié
Date de publication
2008
Volume
48
Numéro
6 Suppl.
Pages
37S-44S; discussion 45S
Langue
anglais
Notes
Publication types: Journal Article ; Review
Résumé
OBJECTIVE: This review describes and evaluates the results of laparoscopic aortic surgery. METHODS: We describe the different laparoscopic techniques used to treat aortic disease, including (1) total laparoscopic aortic surgery (TLS), (2) laparoscopy-assisted procedures including hand-assisted laparoscopic surgery (HALS), and (3) robot-assisted laparoscopic surgery, with their current indications. Results of these techniques are analyzed in a systematic review of the clinical series published between 1998 and 2008, each containing >10 patients with complete information concerning operative time, clamping time, conversion rate, length of hospital stay, morbidity, and mortality. RESULTS: We selected and reviewed 29 studies that included 1073 patients. Heterogeneity of the studies and selection of the patients made comparison with current open or endovascular surgery difficult. Median operative time varied widely in TLS, from 240 to 391 minutes. HALS had the shortest operating time. Median clamping time varied from 60 to 146 minutes in TLS and was shorter in HALS. Median hospital stay varied from 4 to 10 days regardless of the laparoscopic technique. The postoperative mortality rate was 2.1% (95% confidence interval, 1.4-3.0), with no significant difference between patients treated for occlusive disease or for aneurysmal disease. Conversion to open surgery was necessary in 8.1% of patients and was slightly higher with TLS than with laparoscopy-assisted techniques (P = .07). CONCLUSIONS: Analysis of these series shows that laparoscopic aortic surgery can be performed safely provided that patient selection is adjusted to the surgeon's experience and conversion is liberally performed. The future of this technique in comparison with endovascular surgery is still unknown, and it is now time for multicenter randomized trials to demonstrate the potential benefit of this type of surgery.
Mots-clé
Aortic Diseases/surgery, Humans, Laparoscopy/methods, Treatment Outcome, Vascular Surgical Procedures/methods
Pubmed
Web of science
Open Access
Oui
Création de la notice
03/10/2009 11:53
Dernière modification de la notice
20/08/2019 15:59
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