Al-Otaibi Khalid
Department of Urology, College of Medicine, Imam Abdulrahaman Bin Faisl University, Dammam, Saudi Arabia.
Urol Ann. 2018 Jul-Sep;10(3):308-312. doi: 10.4103/UA.UA_190_17.
The aim of this study is to review the complications of laparoscopic urological procedures performed using a single surgeon during a 12-year period.
From June 2004 to May 2017, a total of 411 abdominal urological procedures were performed using the author. They included 250 varicocele ligations, 94 nephrectomies (simple, partial, radical, and nephroureterectomy), 34 adrenalectomies, 22 renal cyst ablation, and 11 pelvic lymph node dissections. Operative and postoperative complications were reviewed and analyzed. The results were analyzed using Chi-squared tests for statistical analysis.
A total of 55 complications out of 411 procedures occurred in 26 patients with a total complication rate of 13.4%, 19 were major (4.6%), and 36 were minor (8.8%). Mortality occurred in two patients (0.5%). Conversion to open surgery was done in 5 patients (1.2%) to manage uncontrolled bleeding. Major intraoperative complications included vascular injuries (2.2%), injuries to the diaphragm (0.5%), bowel (0.7%), and pancreas (0.5%). Major postoperative complications included urine leak (0.2%) and pelvic lymphocele (0.2%). Minor intraoperative complications included bleeding during trocar access (4.4%) and subcutaneous emphysema (0.7%), whereas minor postoperative complications included atelectasis (1.2%) and ileus (2.2%).
Even though the complications rate in this series was comparable to those of other studies in the literature, yet it remains higher than that of open surgery. The continuing advances in laparoscopic techniques will reduce the complication rate and will pave the way for laparoscopy to replace most currently practiced open surgical urological procedures.
本研究旨在回顾一位外科医生在12年期间实施的腹腔镜泌尿外科手术的并发症。
2004年6月至2017年5月，该作者共实施了411例腹部泌尿外科手术。其中包括250例精索静脉曲张结扎术、94例肾切除术（单纯性、部分性、根治性和肾输尿管切除术）、34例肾上腺切除术、22例肾囊肿消融术和11例盆腔淋巴结清扫术。对手术中和术后并发症进行了回顾和分析。结果采用卡方检验进行统计分析。
411例手术中共有55例并发症发生在26例患者中，总并发症发生率为13.4%，其中19例为严重并发症（4.6%），36例为轻微并发症（8.8%）。2例患者死亡（0.5%）。5例患者（1.2%）因控制不住出血而转为开放手术。主要术中并发症包括血管损伤（2.2%）、膈肌损伤（0.5%）、肠道损伤（0.7%）和胰腺损伤（0.5%）。主要术后并发症包括尿漏（0.2%）和盆腔淋巴囊肿（0.2%）。轻微术中并发症包括穿刺器穿刺时出血（4.4%）和皮下气肿（0.7%），而轻微术后并发症包括肺不张（1.2%）和肠梗阻（2.2%）。
尽管本系列研究中的并发症发生率与文献中其他研究相当，但仍高于开放手术。腹腔镜技术的不断进步将降低并发症发生率，并为腹腔镜取代目前大多数泌尿外科开放手术铺平道路。
