Is Endovascular Retroperitoneoscopic Aortobifemoral Bypass a Reasonable Alternative to Transperitoneal Open Surgery for Treatment of Severe Aorto-Iliac Occlusive Lesions? A Retrospective Comparative Analysis

Author(s):  
Bernard Segers ◽  
Livio Solari ◽  
José Ferrera ◽  
Maurice Sosnowski ◽  
Jean-Claude Wautrecht ◽  
...  
2019 ◽  
Vol 139 (9) ◽  
pp. 1203-1208 ◽  
Author(s):  
Wiktor Urbanski ◽  
Rafał Zaluski ◽  
Anis Kokaveshi ◽  
Silvester Aldobasic ◽  
Grzegorz Miekisiak ◽  
...  

2015 ◽  
Vol 139 (2) ◽  
pp. 300-305 ◽  
Author(s):  
John K. Chan ◽  
Austin B. Gardner ◽  
Katie Taylor ◽  
Caroline A. Thompson ◽  
Kevin Blansit ◽  
...  

2021 ◽  
Vol 22 (4) ◽  
pp. 1641
Author(s):  
Andrea Ascoli Marchetti ◽  
Fabio Massimo Oddi ◽  
Luca Tonidandel ◽  
Alessandro Ranucci ◽  
Cataldo Caruso ◽  
...  

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Yuan-hua Liu ◽  
Hai-tao Dai ◽  
Chang-mao Liu ◽  
Jiang Zheng

Objectives: To explore the clinical effect and safety of laparoscopic radical cystectomy + orthotopic ileal neobladder and open surgery. Methods: The study was conducted at Jingzhou First People’s Hospital from January 2017 to July 2018. In this study 87 patients undergoing radical cystectomy + orthotopic ileal neobladder were chosen and classified into an observation group (48 cases) and a control group (39 cases) according to the surgical methods. The observation group underwent laparoscopic surgery, while the control group underwent open surgery. Perioperative period and prognostic conditions were compared in both groups. Results: The intraoperative bleeding amount obviously decreased. The recovery time of gastroenteric function and postoperative hospitalization time were significantly shortened. Postoperative pain was significantly alleviated. Compared with the control group, the observation group showed significant differences (P<0.05). The time, amount and difference in pelvic lymph node dissection in both groups were not significantly different (P>0.05). The differences in both groups in terms of the daytime/nighttime urinary continence rate, maximum urinary flow rate, internal bladder pressure, maximum bladder pressure during urination, internal urethral pressure, bladder capacity, and residual urine volume six months after the operation were not statistically significant (P>0.05). There was no significant difference in postoperative complications, including urinary fistula, bleeding, urinary tract infection, pulmonary infection, dysuria, lymphatic leakage, ureterostenosis, or relapse (P>0.05). The ileus incidence rate in the observation group was obviously lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: Laparoscopic radical cystectomy + orthotopic ileal neobladder has the characteristics of limited trauma, a minimal amount of bleeding and a fast recovery. The functions of orthotopic neobladders are good, and the occurrence rate of postoperative complications is low. In addition, body immunity is protected. Hence, this procedure deserves to be promoted clinically. doi: https://doi.org/10.12669/pjms.37.1.2273 How to cite this:Liu YH, Dai HT, Liu CM, Zheng J. Comparative analysis of the clinical effect and safety of Laparoscopic Radical Cystectomy + Orthotopic Ileal Neobladder and Open Surgery. Pak J Med Sci. 2021;37(1):59-64. doi: https://doi.org/10.12669/pjms.37.1.2273 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2019 ◽  
Vol 54 (2) ◽  
pp. 102-110 ◽  
Author(s):  
João Rocha-Neves ◽  
André Ferreira ◽  
Joel Sousa ◽  
António Pereira-Neves ◽  
José Vidoedo ◽  
...  

Objective: Compare technical, clinical, and economic outcomes between endovascular and open approaches in patients with type D aortoiliac occlusive disease according to the TransAtlantic Inter-Society Consensus. Methods: Patients undergoing revascularization for type D aortoiliac lesions, either endovascular or open surgery approach, from 2 Portuguese institutions between January 2011 and October 2017 were included. The surgical technique was left to the surgeon discretion. Patients with common femoral artery affection, both obstructive and aneurysmatic, were excluded. Results: Twenty-seven patients underwent aortobifemoral bypass and 32 patients were submitted to endovascular repair. The patients undergoing endovascular procedure were more likely to present with chronic heart failure ( P = .001) and chronic kidney disease ( P = .022) and less likely to have a history of smoking ( P = .05). The mean follow-up period was 67.84 (95% confidence interval = 61.85-73.83) months. The open surgery approach resulted in a higher technical success ( P = .001); however, limb salvage and patency rates were not different between groups. Endovascular approach was associated with a shorter length-of-stay, both inpatient (6 vs 9 days; P = .041) and patients admitted in the intensive care unit (0 vs 3.81 days; P = .001) as well as lower hospital expenses (US$9281 vs US$23 038; P = .001) with a similar procedure cost (US$2316 vs US$1173; P = .6). No differences were found in the postsurgical quality of life. Conclusion: Endovascular approach is, at least, clinically equivalent to open surgery approach and is more cost-efficient. The “endovascular-first” approach should be considered for type D occlusive aortoiliac lesions.


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