Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.
Acta Anaesthesiol Scand. 2012 Apr;56(4):504-6. doi: 10.1111/j.1399-6576.2011.02576.x. Epub 2011 Nov 1.
The objective of this study was to verify whether or not the incidence of post-operative corneal injuries (PCIs) in patients who undergo laparoscopic gynecologic surgery is higher than patients who undergo non-laparoscopic gynecologic surgery.
The peri-operative variables were extracted from the medical records of patients who underwent gynecologic surgery under general anesthesia at our institute between January 2004 and June 2010. The extracted variables were age, day of week of surgery, type of surgery (laparoscopy vs. non-laparoscopy), surgical scheduling (elective vs. emergent), pre-operative hemoglobin, surgery time, peri-operative transfusions, and PCIs. The association of peri-operative variables with PCIs was examined using univariate and multivariate analyses.
A total of 6992 consecutive patients were included in this study. PCIs occurred in 23 patients (0.3%). Based on univariate analysis, the type of surgery and surgery times were associated with PCIs. Based on multivariate analysis, laparoscopy and lengthy surgery times significantly increased the risk for PCIs. The median duration of PCI symptoms was 3 days (range, 1-11 days); no patient had long-term sequalae.
Laparoscopic gynecologic surgery increases the incidence of PCI compared with non-laparoscopic gynecologic surgery.
本研究旨在验证行腹腔镜妇科手术的患者术后角膜损伤(PCIs)的发生率是否高于行非腹腔镜妇科手术的患者。
从 2004 年 1 月至 2010 年 6 月在我院行全麻下妇科手术的患者病历中提取围手术期变量。提取的变量包括年龄、手术日期(周几)、手术类型(腹腔镜 vs. 非腹腔镜)、手术安排(择期 vs. 急诊)、术前血红蛋白、手术时间、围手术期输血和 PCIs。使用单因素和多因素分析检查围手术期变量与 PCIs 的关系。
本研究共纳入 6992 例连续患者。23 例(0.3%)发生 PCIs。基于单因素分析,手术类型和手术时间与 PCIs 相关。基于多因素分析,腹腔镜和较长的手术时间显著增加了 PCI 的风险。PCI 症状的中位数持续时间为 3 天(范围为 1-11 天);无患者有长期后遗症。
与非腹腔镜妇科手术相比,腹腔镜妇科手术会增加 PCI 的发生率。