经腹腹腔镜治疗上尿路疾病术后并发症分级及相关危险因素的初步研究

Preliminary analysis of postoperative complications classification and risk factors of transperitoneal laparoscopic treatment for upper urinary tract diseases

目的:探讨经腹腹腔镜上尿路疾病术后并发症分级及相关危险因素。方法:回顾性分析2018年6月1日-2021年3月31日广西医科大学第一附属医院泌尿外科同一术者经腹入路腹腔镜技术治疗127例上尿路疾病患者的临床资料。应用Clavien-Dindo分级系统评估术后并发症发生率和分级,探讨并发症相关危险因素。结果:Clavien-Dindo分级系统评估术后并发症发生率11.02%(14/127)。发生并发症23例次,Ⅰ、Ⅱ、Ⅲ级并发症分别为14、8、1例次,Ⅰ~Ⅱ级占95.60%(22/23)。单因素分析结果显示:患者年龄、性别、体重指数、高血压病、糖尿病、心肺疾病、麻醉ASA分级、手术级别及术中出血量与术后并发症无相关性(P>0.05),手术时间及术中穿刺通道数量与术后并发症有相关性(P<0.05)。多因素分析结果显示:手术时间可能是术后并发症的独立危险因素(P<0.05)。结论:经腹入路腹腔镜上尿路手术术后并发症发生率少,分级低,具有安全性和可行性。手术时间越长,术后发生并发症风险可能越大。

Objective:To investigate postoperative complications and risk factors of transperitoneal laparoscopic treatment for upper urinary tract diseases.Methods:The clinical data of 127 patients with upper urinary tract diseases who underwent transperitoneal laparoscopic surgery by the same surgeon in the department of urology of First Affiliated Hospital of Guangxi Medical University between June 1st,2018 and March 31st,2021 were retrospectively analyzed.The incidence and classification of postoperative complications were assessed by Clavien-Dindo grading system.The risk factors of postoperative complications were investigated.Results:The incidence of post-operative complications was 11.02%(14/127)by Clavien-Dindo grading system.The total of 23 cases/numbers of complications were encountered.There were 14,8,and 1 cases/numbers of grade Ⅰ,Ⅱ,and Ⅲ complications.respectively.The proportion of grades Ⅰ-Ⅱ accounted for 95.60%(22/23).The results of univariate analysis showed that age,sex,BMI,hypertension,diabetes,cardiopulmonary disease,the grade of American Society of Anesthesia(ASA),operation grade and intraoperative blood loss were not significantly correlated with postoperative complications(P>0.05).The operation time and the number of trocar during operation were correlated with postoperative complications after surgery(P<0.05).The results of multivariate analysis demonstrated that operation time was an independent risk factor for postoperative complications(P<0.05).Conclusion:Transperitoneal laparoscopic surgery has less complications and low grade,so it's safe and feasible.The longer the operation time.the greater risk the postoperative complications.