后腹腔镜手术的并发症及其防治策略

The prevention and treatment of complications of retroperitoneal laparoscopy in urlogy

目的分析后腹腔镜泌尿外科手术发生并发症的原因和防治措施。方法总结开展后腹腔镜手术治疗泌尿系疾病发生的各种并发症,并对其发生原因进行分析。结果本组148例手术中出现并发症共18例,占12.16%,严重并发症5例(3.38%),包括下腔静脉损伤2例、十二指肠损伤1例、胸膜损伤2例;轻度并发症13例(8.78%),包括腹膜撕裂6例、皮下气肿7例;有4例中转开放手术。结论在后腹腔镜手术开展的学习曲线阶段,由于经验不足,手术并发症发生率较高。部分并发症需要中转开放手术,严重者可危及患者生命。因此,临床医生对于后腹腔镜手术的各种并发症及其发生因素和防治策略要有充分的认识。

Objective To analyze the causes of complications of retroperitoneoscopic surgery in urology for comprehensive prevention. Methods It is analysed to the data regarding complications of retroperitoneoscopic technique in urology in our hospital between January 2003 and May 2007. Results There were 18 cases of patients with complications who had underwent the laparoscopic operations in this group （12.16%）. The serious complications included 2 cases of inferior venae cava ,2 cases of pleura trauma （2 case）, 1 case of serious hyperearbia and acidosis and 1 case of clip renal artery by accident. The other mild ones were composed of 6 cases of peritoneum trauma and 7 of pneumoderma. 4 out of 18 cases who had complications were transfered to open surgery. Conclusions The morbidity of complication of urological laparoscopy maybe relatively high during the learning curve stage for those urologists who perform laparoscopic surgery in the beginning. Consideration should be taken to avoid the life threatening injuries.