Lin Yu-Hung, Chung Hsiao-Jen, Lin Alex T L, Chang Yen-Hwa, Huang William J S, Hsu Yen-Shen, Chang Shyh-Chyi, Chen Kuang-Kuo
Division of Urology, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2007 Nov;70(11):481-5. doi: 10.1016/S1726-4901(08)70045-5.
We present our experience of complications of pure transperitoneal laparoscopic surgery in urology at Taipei Veterans General Hospital.
Between September 2003 and March 2006, 185 laparoscopic urologic operations were performed, consisting of 70 nephrectomies (36 radical, 17 partial, 11 simple, 6 donor), 28 adrenalectomies, 28 nephroureterectomies, 22 radical prostatectomies, 17 ureterolithotomies, 6 radical cystectomies, 5 pyeloplasties, 2 renal cyst unroofings, 2 nephropexies and 5 other operations. We reviewed the database of the patients to evaluate the complications and analyze factors related to laparoscopic surgeries.
A total of 25 patients had 26 complications (14.1%, major in 4, minor in 22). The complications were categorized into intraoperative and postoperative complications in 10 and 16 patients, respectively. The mortality rate was 0%. The conversion rate was 0.54% (1 patient). The re-operation rate was 1.08% (2 patients). The most common intraoperative complication was vascular injury (5 patients). The incidence of complication was related to the difficulty level of operation. No statistically significant differences were found between complication rate and patient age, patient body mass index or the American Society of Anesthesiologist score.
The complications of laparoscopic urologic surgeries are strongly correlated with the operative difficulties. In spite of elevated complication rates in difficult surgeries, the major complication rate in this study was very low. As the laparoscopic surgeries in urology involve more and more technique-dependent difficult fields, documentation and analysis of experience of complications is important for the development of this surgical modality.
我们介绍台北荣民总医院泌尿外科单纯经腹腹腔镜手术并发症的经验。
2003年9月至2006年3月期间，共进行了185例腹腔镜泌尿外科手术，包括70例肾切除术（36例根治性、17例部分性、11例单纯性、6例供体）、28例肾上腺切除术、28例肾输尿管切除术、22例根治性前列腺切除术、17例输尿管切开取石术、6例根治性膀胱切除术、5例肾盂成形术、2例肾囊肿去顶术、2例肾固定术及5例其他手术。我们回顾患者数据库以评估并发症并分析与腹腔镜手术相关的因素。
共有25例患者出现26种并发症（14.1%，4例为严重并发症，22例为轻微并发症）。并发症分别在10例和16例患者中分为术中并发症和术后并发症。死亡率为0%。中转率为0.54%（1例患者）。再次手术率为1.08%（2例患者）。最常见的术中并发症是血管损伤（5例患者）。并发症发生率与手术难度级别相关。并发症发生率与患者年龄、患者体重指数或美国麻醉医师协会评分之间未发现统计学显著差异。
腹腔镜泌尿外科手术的并发症与手术难度密切相关。尽管困难手术的并发症发生率有所升高，但本研究中的严重并发症发生率非常低。随着泌尿外科腹腔镜手术涉及越来越多技术依赖的困难领域，并发症经验的记录和分析对于这种手术方式的发展很重要。
