Perioperative humoral stress response to laparoscopic versus open aortobifemoral bypass surgery

Krog, Anne Helene; Thorsby, Per Medbøe; Sahba, Mehdi; Pettersen, Erik Mulder; Sandven, Irene; Jørgensen, Jørgen J.; Sundhagen, Jon Otto; Kazmi, Syed Sajid Hussain

doi:10.1080/00365513.2016.1268264

Cited by 14 publications

(9 citation statements)

References 50 publications

(57 reference statements)

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“…This may be due to the less-invasive nature of the LABFB procedure. Recently, in a randomized controlled trial of LABFB and OABFB for AIOD, TASC II type D lesions, less postoperative inflammatory response as well as reduced perioperative stress response were found in patients with LABFB 24,25. Improvement in the quality of life in the patients found in this study after LABFB also adds to the collective evidence of the effectiveness of LABFB.…”

Section: Discussionsupporting

confidence: 63%

Patient-perceived health-related quality of life before and after laparoscopic aortobifemoral bypass

Kazmi

Krog

Berge

et al. 2017

VHRM

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BackgroundIn patients operated with laparoscopic aortobifemoral bypass (LABFB) for atherosclerotic obstruction in aortoiliac segment, the main focus of the reports published during the last two decades has been morbidity and mortality. The primary objective of this study was to examine the health-related quality of life (HRQL) in these patients before and after LABFB.Patients and methodsFifty consecutive patients (27 females) with Trans-Atlantic Inter-Society Consensus II, type D lesions were prospectively included. Short-Form 36 (SF-36) questionnaire was used to get information about the HRQL before LABFB and at 1, 3 and 6 months after the operation. Main indication for LABFB was intermittent claudication. Linear mixed-effect models were used to assess changes in HRQL over time. Age, gender, smoking, blood loss, operation time, concomitant operation, the American Society of Anesthesiologists category, length of hospital stay, previous vascular procedures and aorta cross-clamping were used as fixed factors and their impact on the physical components of the SF-36, as well as the summary scores were determined with univariate analysis. Variables with P<0.2 were included in the multivariate regression analysis. P<0.05 was considered statistically significant.ResultsStatistically significant improvement was found in all SF-36 domains as well as in the summary scores after LABFB compared to the preoperative scores. The improvement in scores was substantial already at 1 month and the effect was maintained at 3 and 6 months survey time points. Concomitant operations had a statistically significant negative impact on the physical components of SF-36. Data completeness of item questionnaires was 93% in the whole material. Reliability scale and homogeneity estimates for the eight domains had high internal consistency.ConclusionPatients operated with LABFB for Trans-Atlantic Inter-Society Consensus II, type D lesions have reduced HRQL. LABFB leads to substantial and statistically significant improvement in the patients’ HRQL, when examined with SF-36. These results need to be replicated by a randomized clinical trial.

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Section: Discussionsupporting

confidence: 63%

Patient-perceived health-related quality of life before and after laparoscopic aortobifemoral bypass

Kazmi

Krog

Berge

et al. 2017

VHRM

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“…This project is a substudy of the NLAST,15,16 where patients with AIOD classified according to the Trans-Atlantic Inter-Society Consensus II (TASC-II) as type D lesions are randomized to either LABF or OABF 27. Inclusion and exclusion were based on the following criteria.…”

Section: Methodsmentioning

confidence: 99%

“…The laparoscopic aortobifemoral bypass (LABF) has become an established treatment option for symptomatic AIOD at many dedicated centers 6–11. At Oslo University Hospital, we introduced the laparoscopic technique in 2005,12–14 and since February 2013, we have been conducting a randomized controlled trial,15,16 to compare the early morbidity after the two treatment methods.…”

Section: Introductionmentioning

confidence: 99%

Cost-utility analysis comparing laparoscopic vs open aortobifemoral bypass surgery

Krog

Sahba

Pettersen

et al. 2017

VHRM

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ObjectivesLaparoscopic aortobifemoral bypass has become an established treatment option for symptomatic aortoiliac obstructive disease at dedicated centers. Minimally invasive surgical techniques like laparoscopic surgery have often been shown to reduce expenses and increase patients’ health-related quality of life. The main objective of our study was to measure quality-adjusted life years (QALYs) and costs after totally laparoscopic and open aortobifemoral bypass.Patients and methodsThis was a within trial analysis in a larger ongoing randomized controlled prospective multicenter trial, Norwegian Laparoscopic Aortic Surgery Trial. Fifty consecutive patients suffering from symptomatic aortoiliac occlusive disease suitable for aortobifemoral bypass surgery were randomized to either totally laparoscopic (n=25) or open surgical procedure (n=25). One patient dropped out of the study before surgery. We measured health-related quality of life using the EuroQol (EQ-5D-5L) questionnaire at 4 different time points, before surgery and for 6 months during follow-up. We calculated the QALYs gained by using the area under the curve for both groups. Costs were calculated based on prices for surgical equipment, vascular prosthesis and hospital stay.ResultsWe found a significantly higher increase in QALYs after laparoscopic vs open aortobifemoral bypass surgery, with a difference of 0.07 QALYs, (p=0.001) in favor of laparoscopic aortobifemoral bypass. The total cost of surgery, equipment and hospital stay after laparoscopic surgery (9,953 €) was less than open surgery (17,260 €), (p=0.001).ConclusionLaparoscopic aortobifemoral bypass seems to be cost-effective compared with open surgery, due to an increase in QALYs and lower procedure-related costs.

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“…Krog's study [30] showed that Cortisol and ACTH levels are statistically lower in laparoscopic aortabifemoral bypass group than open aorta-bifemoral bypass group. The patients operated with a laparoscopic aorta-bifemoral bypass achieved earlier hormonal homeostasis after surgery compared to open group [30]. Minimally invasive surgery seems to reduce hormonal stress response to surgery.…”

Section: ! "#$%And'()*!+($'! -*!!/01! 234$%and'()*!+($'!! -*!!/01! !!4)and'3!mentioning

confidence: 97%

Comparison of the effects of isoflurane and sevoflurane on surgical stress in intracranial tumor surgery

Erdem

Sayan

Korfali

2021

The European Research Journal

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Objectives: Surgeries can trigger stress responses including metabolic and hormonal changes. It is important to suppress stress response during surgery. We compared the effects of isoflurane and sevoflurane on surgical stress in intracranial tumor surgery. Methods: Thirty ASA physical status I, II, III patients, scheduled for elective craniotomies, were enrolled in this prospective, randomized study. Anesthesia was induced with sodium thiopental fentanyl and vecuronium bromide and maintained with a 50% oxygen-air mixture along with isoflurane or sevoflurane. Venous blood was sampled to measure cortisol, ACTH and prolactin levels 24 hours before surgery, 1 min before anesthesia induction, during tumor removal, 1 min after extubation, at 3, 6, 12, 24, 48 hours. Results: There was no statistically significant difference between two groups regarding demographic characteristics of patients. In group I, ACTH levels were significantly higher 1 min after extubation, at 3 and 6 hours. In Group S, significant increases were observed during tumor removal, 1 min after extubation, at 3 and 6 hours. Cortisol levels were significantly higher in both group after tumor removal, 1 min after extubation, at 3, 6, 12 and 24 hours. Prolactin levels were significantly higher in Group I during tumor removal, after extubation, at 3 and 6 hours. In group S, significant increase in prolactin level was observed only during tumor removal and 1 min after extubation. There were no significant differences in ACTH, cortisol and prolactin values between the two groups. Conclusions: Using isoflurane or sevoflurane for anesthesia during intracranial tumor surgery are not superior to each other regarding hemodynamic and hormonal stress response.

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Perioperative humoral stress response to laparoscopic versus open aortobifemoral bypass surgery

Abstract: Background

Cited by 14 publications

References 50 publications

Patient-perceived health-related quality of life before and after laparoscopic aortobifemoral bypass

Patient-perceived health-related quality of life before and after laparoscopic aortobifemoral bypass

Cost-utility analysis comparing laparoscopic vs open aortobifemoral bypass surgery

Comparison of the effects of isoflurane and sevoflurane on surgical stress in intracranial tumor surgery

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