title: [Complications of retroperitoneal laparoscopy based on a series of 500 cases].
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service d'Urologie, CHU Henri Mondor, Créteil, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Demey
authors.forename: Alexandre
authors.initials: A
authors.lastname: de la Taille
authors.forename: Dimitri
authors.initials: D
authors.lastname: Vordos
authors.forename: Andras
authors.initials: A
authors.lastname: Hoznek
authors.forename: Dominique K
authors.initials: DK
authors.lastname: Chopin
authors.forename: Claude-Clément
authors.initials: CC
authors.lastname: Abbou
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
mesh_terms: D000315:Adrenalectomy / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D014513:Ureter / Q000601:surgery*