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目的:探讨泌尿系腹腔镜手术并发症的原因及防治措施方法:回顾性分析2003年9月～2007年9月间行经腹腔镜和经后腹腔镜泌尿系手术的883例患者临床资料,其中经腹腔组74例,经后腹腔组809例,并对其临床诊断、手术方式、手术路径、手术时间、并发症发生率、术后住院时间等情况进行统计学比较分析。结果:883例患者中,出现并发症85例,占9.6%,无死亡病例,其中经腹腔组出现并发症8例(10.8%),经后腹腔组出现并发症77例(9.5%),组间比较差异无统计学意义(P>0.05)。经腹腔组平均手术时间(121±46)min,经后腹腔组平均手术时间(82±72)min,组间比较差异有统计学意义(P<0.01)。经腹腔组平均术后住院时间(6.5±3.1)天,经后腹腔组平均术后住院时间(5.8±2.2)天,组间比较差异有统计学意义(P<0.05)。按2003、2004、2005、2006、2007年度划分,手术并发症发生率分别为31.2%(10/32)、11%(16/145)、7.9%(20/252)、8.3%(22/265)、9.5%(17/189),组间比较差异有统计学意义(P<0.01)。结论:经腹腔和经后腹腔镜手术并发症发生率无明显差异,经腹腔路径的平均手术时间、平均术后住院时间均长于经后腹腔路径,腹腔镜手术并发症总体发生率随手术开展时间的延长而降低。通过熟悉并发症的特点,采取妥善的应对措施,可以有效减少泌尿系后腹腔镜手术并发症的发生。
Objective: To investigate the causes and prevention and treatment of complications of urinary laparoscopic surgery.Methods: The clinical data of 883 patients who underwent laparoscopic and retroperitoneal laparoscopic urological surgery from September 2003 to September 2007 were retrospectively analyzed. Among them, 74 cases in the abdominal cavity group and 809 cases in the posterior abdominal cavity group. The clinical diagnosis, operation methods, operation path, operation time, complication rate and postoperative hospital stay were statistically analyzed. Results: Of the 883 patients, 85 patients (9.6%) had no complication, 8 patients (10.8%) had complications in the abdominal cavity group, 77 (9.5%) patients in the posterior abdominal cavity group had complications There was no significant difference between the two groups (P> 0.05). The mean operative time (121 ± 46) min in the abdominal cavity group and 82 ± 72 min in the retroperitoneal abdominal cavity group were significantly different (P <0.01). The average postoperative hospital stay (6.5 ± 3.1) days in the abdominal cavity group and the average postoperative hospital stay in the posterior abdominal group (5.8 ± 2.2 days) were statistically significant (P <0.05). The incidence of complications was 31.2% (10/32), 11% (16/145), 7.9% (20/252), 8.3% (22/265) according to the year of 2003, 2004, 2005, ) And 9.5% (17/189), respectively. The difference between the two groups was statistically significant (P <0.01). Conclusions: There is no significant difference in the incidence of complications between transperitoneal and retroperitoneal laparoscopic surgery. The mean operative time and average postoperative hospitalization time of the transabdominal path are longer than that of the retroperitoneal path. The overall incidence of complications of laparoscopic surgery depends on the operation time The decrease of the extension. By familiar with the characteristics of complications, and take appropriate measures to reduce the complications of urinary laparoscopic surgery.