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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Nabil Chakfe, Hopitaux Universitaires de Strasbourg, France
- Second opponent: Professor Arne Seternes, NTNU: Norwegian University of Science and Technology,
- Third member and chair of the evaluation committee: Professor Kristin Bjørnland, University of Oslo
Chair of the Defence
Professor Sheraz Yaqub, University of Oslo
Principal Supervisor
Professor Syed Sajid Hussain Kazmi, University of Oslo
Summary
Atherosclerotic stenosis or occlusion in the abdominal aorta and iliac arteries result in reduced blood circulation to the lower extremities. Lower extremity pain during walking and in more severe cases, rest pain, or development of ulcers are common symptoms, besides, a reduced functional capacity and poor health-related quality of life.
The standard operative treatment for occluded arteries in the abdominal aorta and/or iliac arteries has been an open bypass surgery. Through laparotomy and bilateral groin incisions, a synthetic graft is used to bypass the stenotic or occluded segment of the aorta and bilateral iliac arteries (aortobifemoral bypass). Laparoscopic surgery was introduced in the early 90s as a minimally invasive alternative to open bypass. To this date no randomized studies have been completed to compare laparoscopic and open aortobifemoral bypass procedures.
This thesis, based on a multicentre randomized controlled trial, namely, Norwegian Laparoscopic Aortic surgery Trial (NLAST), aimed to compare the laparoscopic technique with standard open aortobifemoral bypass surgery and evaluate whether patients with aortobiliac occlusive disease, classified as Transatlantic InterSociety Concensus TASC II Type D lesions, undergoing laparoscopic bypass experience fewer complications than those receiving open surgery.
The results show that patients treated by laparoscopic bypass have fewer postoperative complications compared to open aortobifemoral bypass surgery. The incidence of serious postoperative complications was also lower in laparoscopic treatment group.
Furthermore, patients in the laparoscopic treatment group reported significantly improved health-related quality of life for up to two years after surgery. In addition, the in-hospital costs were lower for the laparoscopic procedure during the first 30 postoperative days. Laparoscopic aortobifemoral bypass was shown to be more cost-effective than open surgery for up to six months postoperatively.
The thesis concludes that laparoscopic aortobifemoral bypass as compared with the open operation, is a treatment option with fewer complications and higher cost-effectiveness for occlusion or significant stenosis of the abdominal aorta and/or iliac arteries.
Additional information
Contact the research support staff.