Comparative study of totally laparoscopic and open main bilateral femoral artery bypass for the treatment of advanced atherosclerosis

Abstract

Objective To comparatively complete clinical effectiveness of laparoscopic and open- bifemoral bypass in the treatment of advanced atherosclerosis. Methods During January 2008 to January 2013, according to the treatment method, a total of 60 patients with advanced atherosclerosis patients were divided into group A and group B, and there were 30 cases in each group, and group A was treated with open master bifemoral bypass surgery, and group B was treated with laparoscopic totally master bifemoral bypass surgery, to compare the general information of the two groups, surgery related indicators, clinical efficacy and survival rate, and to analyze the effect of surgical treatment on the prognosis of patients by COX model. Results The operation time of patients in group B (365.3±41.3) min and aortic clamping time (59.5±18.3) min were significantly higher than that of group A, (294.3±35.5) min and(26.5±19.3) min (P<0.05), bleeding amount (400.0±145.3) ml and length of hospital stay (10.5±2.1) d of group B patients was significantly lower than that of group A (1 002.3±324.3) ml and (16.4±4.3) d (P<0.05); postoperative mortality, thrombosis rate and the incidence of serious complications of patients in group B were significantly lower than group A(P<0.05); survival rate at different time of group B was significantly higher than that of group A(P<0.05); COX model analysis show that the surgical methods affect the postoperative mortality, thrombosis and the occurrence of severe complications. Conclusions Completely laparoscopic master bifemoral bypass can significantly decreased advanced main iliac artery occlusion disease mortality, and has small surgical trauma, less postoperative complications, rapid recovery and other advantages, especially for elderly critically ill patients, and it was worthy of clinical application. Key words: Laparoscopes; Atherosclerosis; Bypass surgery; Femoral artery