Analyzing Complications Of 47 Cases Of Laparoscopic Gynecologic Surgery

Objective:To investigate the causes and prevention of the complications of laporoscopic gynecologic surgery.Methods:A retrospective analysis was done based on clinical data of 13665 cases of laporoscopic gynecologic surgery from January 2003 to December 2010 in Dalian Maternity Hospital, summary 47 cases of complication related causes and prevention measures.Results:First, Dalian Maternity Hospital were 35998 cases total surgery gynaecology from January 2003 to December 2010, laparoscopic surgery 13665 cases, laparoscopic surgery rate 38﹪, 47 cases of complications, the complications rate of 0.34, slightly lower than reported in literature. laparoscopic surgery complications from 2003 to 2010 overall declines. In 2003, for 0.48﹪of peak,of lowest in 2010 for 0.28﹪. Second, annual complications change trend from 2003 to 2010:in 2003 laparoscopic surgical complications happened in adnexal operations(Ⅰ,Ⅱkind of surgery); in 2004 complications occurred in adnexal operations(Ⅰ,Ⅱkind of surgery) and myomectomy (Ⅲkind of surgery); laparoscopic complications from 2005 to 2007 occurred in myomectomy and hysterectomy(Ⅲkind of surgery);laparoscopic complications from 2008 to 2010 occur predominantly in the hysterectomy(Ⅲkind of surgery) and malignant tumors(Ⅳkind of surgery). Third, four laparoscopic surgical groups, surgical complications are statistically significant differences in comparison. adnexal operations with each comparison, surgical difference was statistically significant; malignant tumor with other groups comparison, there was a statistically significant in complication rate; the occurrence rates of complications between myomectomy and hysterectomy were no difference. Fourth, having surgeries group with no operative history comparative differences of complications was not statistically significant. Fifth, subcutaneous emphysema 9 cases, abdominal wall 6 cases, hemorrhage 9 cases, stomach injury 1 case, intestinal injuries 4 cases, urinary bladder injuries 7 cases, ureteral injuries 7 cases, obturator nerve damage 1 case, in 2 cases incisional hernia, IUD legacy in one.Conclusions:First, from January 2003 to December 2010 gynecological laparoscopic surgery complications in Dalian Maternity Hospital was 0.34, slightly lower than reported in literature. 2003-2010 laparoscopic surgery complications overall declines. Second, laparoscopic surgery complications changes with surgical methods, that is, from simpleⅠ,Ⅱkind of surgery turned to complexⅢ,Ⅳkind of surgery. Since 2008, radical surgery in malignant tumor ofⅣcomplications rose. Third, laparoscopic surgery complications related with operation difficulty closely. operation difficulty small, complication rate is low; operation difficulty increase, complication rate rose. Fourth, laparoscopic complications was not relative with operative history.Fifth, prevention measures of laparoscopic surgery complications: (1) Strictly choicing laparoscopic surgical indications is to reduce the premise condition of complications. (2) Improving surgical technique and undertaking normal operation training is to reduce the key link of complications. (3)In the process of intraoperative difficult operation, timely transferred to opening appendectomy is to the important measure of reducing complications. (4) It is remedial measures of minimizing the damage degree of complication to master the characteristics, regularity, prevention and control methods of laparoscopic complications; moreover discover timely and manage complications.