Minimally Invasive or Conventional Aorto-bifemoral By-pass. A Randomised Study

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.