Riedel H H, Lehmann-Willenbrock E, Semm K
Frauenklinik des Städtischen Heinrich Braun Klinikums Zwickau.
Zentralbl Gynakol. 1993;115(5):210-9.
The fourth German pelviscopy/laparoscopy statistical report includes survey data on a total of 219,314 laparoscopies from 354 clinics and 40,892 laparoscopies from 161 private practices. Clinics' response rate was 44.7%, 98.9% of them reported performing laparoscopies; and the number of serious complications requiring laparotomy or control laparoscopy was 492 (2.2/1,000). For private practices, the comparable figures were 66%, 90.8% and 123 (3/1,000), respectively. Compared with data from the third laparoscopy statistical survey, the data show a slight increase in serious complications, most of which were mechanical lesions of blood vessels in the abdominal wall or in the mesosalpinx, followed by mechanical lesions of the intestine. As shown by the previous survey, 16.5% of the complications were burns. For tubal sterilization, bipolar techniques were still predominant; approximately equal numbers of departments used this method, with or without subsequent transsection of the tubes. Endocoagulation by the method of Semm was the second most popular procedure; the use of clips and rings was of little significance. Monopolar high-frequency (HF) current was still used with transsection by 4.1% of clinics (4.7% of private practices) and without transsection by 2.5% (5.3%). Sterilization failure rates remained the same as those previously reported (2.5/1,000 in clinics, 2.8/1,000 in private practices), the highest rates were observed after the use of monopolar HF techniques. Sixty-six percent of the clinics and 41% of the private practices reported their intention to increase the use of endoscopic operational methods.
第四份德国盆腔镜检查/腹腔镜检查统计报告包含了来自354家诊所的总共219,314例腹腔镜检查以及161家私人诊所的40,892例腹腔镜检查的调查数据。诊所的回复率为44.7%,其中98.9%报告进行了腹腔镜检查;需要开腹手术或控制性腹腔镜检查的严重并发症数量为492例(每1000例中有2.2例)。对于私人诊所,相应的数据分别为66%、90.8%和123例(每1000例中有3例)。与第三次腹腔镜检查统计调查的数据相比,数据显示严重并发症略有增加,其中大多数是腹壁或输卵管系膜血管的机械性损伤,其次是肠道机械性损伤。如先前调查所示,16.5%的并发症为烧伤。对于输卵管绝育术,双极技术仍然占主导地位;使用该方法的科室数量大致相等,无论是否随后切断输卵管。Semm法内膜凝固是第二常用的手术方法;夹子和环的使用意义不大。4.1%的诊所(4.7%的私人诊所)仍使用单极高频电流并进行切断,2.5%(5.3%)的诊所不进行切断。绝育失败率与先前报告的相同(诊所中每1000例中有2.5例,私人诊所中每1000例中有2.8例),单极高频技术使用后观察到的失败率最高。66%的诊所和41%的私人诊所报告有意增加内镜手术方法的使用。