[Analysis of complications about gynecologic endoscopic procedures in 14 hospitals of Shanghai during 1992-2001].
OBJECTIVE
To investigate the objective law of complication in endoscopic operation of gynecology.


METHODS
We retrospectively reviewed and analyzed the complications of endoscopic surgery during the decade occurred in 9 municipal or teaching hospitals and 5 district hospitals in Shanghai.


RESULTS
There were total 10,263 cases of operative laparoscopy and 18,306 cases of hysteroscopy. The laparoscopic complication rate was 1.51% (155/10,263) and incidence of hysteroscopic complication was 0.09% (16/18,306). The major common complications in laparoscopic procedures were bleedings (70/10,263, 0.68%), 18 infections (18/10,263, 0.18%) and 12 organic injuries (12/10,263, 0.12%). The complication rate in laparoscopic surgery made by the inexperienced was six times greater than that by the experienced (P < 0.01). Complication rate decreased to 0.90% in 2001 from 7.25% in 1992. The complications in hysteroscopy were 6 uterine perforations, 3 hyperhydration syndromes, 3 postoperative bleedings, 2 cardio-brain syndrome, 1 organic injury, and 1 died. The mortality was 0.005%. The complication rate in the hospital developing hysteroscopic surgery less than 1,000 cases was 16 times greater than in that over 1,000 cases (P < 0.01).


CONCLUSIONS
It is suggested by our data that the complication in laparoscopy showed downward year by year and some serious complications were increased with extension of operative surgery. Complication has to do with the experience of surgeons. To decrease complication, surgeons should pay a great attention to the indication chosen correctly, training step by step and basic skills.
Liu
Yan
Y
Department of Obstetrics and Gynecology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
Zhang
Xiyin
X
D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000009:adverse effects*; D012189:Retrospective Studies