Key result
Totally laparoscopic and laparoscopic-assisted abdominal aortic aneurysm repair had 30-day mortality of 0-6% and 0-7%, respectively, with conversion to open repair in 5-30% and 5-10% of cases.
Why the study?
Does elective laparoscopic abdominal aortic aneurysm repair improve perioperative outcomes in patients with abdominal aortic aneurysms?
Systematic Review (n=849)
Does elective laparoscopic abdominal aortic aneurysm repair improve perioperative outcomes in patients with abdominal aortic aneurysms?
Elective laparoscopic repair of abdominal aortic aneurysms is feasible and appears comparable in safety to open repair, though its advantages over open or endovascular repair remain unclear.
Laparoscopic AAA repair is feasible with low mortality; confirms safety but leaves advantages over open or EVAR unclear.
OBJECTIVE: To collate information available in the literature regarding perioperative outcomes following elective laparoscopic abdominal aortic aneurysm repair. MATERIALS AND METHODS: Electronic databases were searched and a systematic review was performed. In total, 1256 abstracts were screened, from which 10 studies were included for analysis. Perioperative and technical outcomes were analysed. RESULTS: In the totally laparoscopic repair of infra-renal aneurysms (n = 302), 30-day mortality ranged between 0% and 6% and in the laparoscopic-assisted cases (n = 547) ranged between 0% and 7%. Of the former group, 5-30% of cases were converted to open repair, with 6% reintervention rate, whereas there was a 5-10% conversion and 3% reintervention rate in the latter group. CONCLUSIONS: The outcomes from selected patients in selected centres demonstrate that elective laparoscopic repair of aortic aneurysms is feasible and comparable in safety to open repair; it remains unclear, however, whether there are substantial advantages of this method compared with open and endovascular repair.
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Rouhani et al. (2014) conducted a systematic review in abdominal aortic aneurysm (n=849). Totally laparoscopic repair vs. Laparoscopic-assisted repair was evaluated on 30-day mortality. Totally laparoscopic and laparoscopic-assisted abdominal aortic aneurysm repair had 30-day mortality of 0-6% and 0-7%, respectively, with conversion to open repair in 5-30% and 5-10% of cases.
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