The Clinical Analysis Of Intraoperative Serious Complications In Laparoscopic Urological Surgery

Objective:Review and analyze the occurrence of the past nine years, the First Affiliated Hospital of Nanchang University Urology laparoscopic surgery serious complications.Methods:Statistics from January 2005 to December 2013, the First Affiliated Hospital of Nanchang University, completed a total of 4380 cases of urological laparoscopic surgery, including laparoscopic adrenalectomy 713 cases, accounting for 16.67%;laparoscopic surgery ureterolithotomy 305 cases, accounting for 7.10%; laparoscopic radical nephrectomy surgery 606 cases, accounting for 14.05%; laparoscopic nephrectomy alone 340 cases, accounting for 7.94%; pelvis laparoscopic radical prostatectomy 152 cases, accounting for 3.55%; intraperitoneal mirror spermatic vein ligation 170 cases, accounting for 3.98%; partial nephrectomy surgery 280 cases,accounting for 6.54%; renal cyst surgery 518 cases, accounting for 12.11%;laparoscopic renal lymphatic vessels ligation 368 cases, accounting for 8.60%;laparoscopic pelvis from paragraph angioplasty 228 cases, accounting for 5.33%;laparoscopic radical prostatectomy 232 cases, accounting for 5.42%; laparoscopic cystectomy surgery 154 cases, accounting for 3. 59%; other surgery 314 cases,accounting for 7.33%. Satava grading system to assess the use of intraoperative complications. Serious complications defined as Satava II level.Result:The group of 4380 cases, surgery CPC 130 cases of serious complications(2.73%), 94 males and 36 females, aged 18 to 82 years(mean 57.2 years), the number of hospital days 7 to 85 days(mean 14.7 days) postoperative hospital stay of 4 to 75days(mean 10.3 days), blood loss 50 ~ 3000ml(mean 653ml), surgery length 70 ~840min(mean 291min). Among them, the small blood vessels damage requiring transfusion 101 cases, hypercapnia and acidosis eight cases, inferior vena cava injury in five cases, one case of abdominal aorta injury, renal artery injury in 2 cases, renal vein injury in 3 cases, external iliac vein injury three cases, one case of the externaliliac artery injury, spleen injury in one case, pleural injury in 3 cases, 2 cases of mild rectal injury.Conclusion:1, our department laparoscopic surgery serious complication rate peaked in 2008,then declining.2, our department laparoscopic surgery, difficult group, very difficult group and easy group of patients there is a significant difference in the incidence of serious complications.3, urological laparoscopic surgery in severe complications often result in serious consequences. To fully understand the characteristics of complications and treatment,helps reduce the incidence of serious complications.