1. [Complications of retroperitoneal laparoscopy based on a series of 500 cases].
- Author
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Demey A, de la Taille A, Vordos D, Hoznek A, Chopin DK, Abbou CC, and Salomon L
- Subjects
- Humans, Postoperative Complications etiology, Adrenalectomy adverse effects, Adrenalectomy methods, Laparoscopy adverse effects, Nephrectomy adverse effects, Nephrectomy methods, Ureter surgery
- Abstract
Objective: To evaluate the complications of retroperitoneal laparoscopy for upper urinary tract surgery., Methods: From 1994 to 2003, 500 retroperitoneal laparoscopy procedures were performed: 143 radical nephrectomies, 104 simple nephrectomies, 95 adrenalectomies, 47 ureteropelvic junction plasties, 44 partial nephrectomies, 22 nephroureterectomies, 20 cyst resections, 9 diverticulectomies, 8 lymphadenectomies, 4 pyelotomies and 4 ureteric procedures. The standardized technique uses 5 trocars., Results: There were 23 conversions (4.60%): 5 for retroperitoneal adhesions, 11 for intraoperative bleeding, 7 for technical impossibility. 14 patients (2.8%) required surgical revision: 5 urinomas and 2 urocutaneous fistulas treated by ureteric drainage, 2 deep abscesses, 2 cases of secondary bleeding, 2 colostomies for gastrointestinal fistula after colonic injury, 1 incisional hernia on a trocar orifice. There were postoperative 2 deaths (0.4%) due to septic shock and haemorrhagic shock. 21 patients (4.2%) presented medical postoperative complications: haematoma, hyperthermia, phlebitis and pulmonary infections. 15 patients (3%) were transfused. The most frequent complications occurred after partial nephrectomies and the most serious complications occurred after radical nephrectomies., Conclusion: The complication rate is low. Retroperitoneal laparoscopy allows reproducible and effective upper urinary tract surgery, but it is not recommended in patients with a history of retroperitoneal surgery.
- Published
- 2006