Complications of pure transperitoneal laparoscopic surgery in urology: the Taipei Veterans General Hospital experience.
BACKGROUND
We present our experience of complications of pure transperitoneal laparoscopic surgery in urology at Taipei Veterans General Hospital.


METHODS
Between September 2003 and March 2006, 185 laparoscopic urologic operations were performed, consisting of 70 nephrectomies (36 radical, 17 partial, 11 simple, 6 donor), 28 adrenalectomies, 28 nephroureterectomies, 22 radical prostatectomies, 17 ureterolithotomies, 6 radical cystectomies, 5 pyeloplasties, 2 renal cyst unroofings, 2 nephropexies and 5 other operations. We reviewed the database of the patients to evaluate the complications and analyze factors related to laparoscopic surgeries.


RESULTS
A total of 25 patients had 26 complications (14.1%, major in 4, minor in 22). The complications were categorized into intraoperative and postoperative complications in 10 and 16 patients, respectively. The mortality rate was 0%. The conversion rate was 0.54% (1 patient). The re-operation rate was 1.08% (2 patients). The most common intraoperative complication was vascular injury (5 patients). The incidence of complication was related to the difficulty level of operation. No statistically significant differences were found between complication rate and patient age, patient body mass index or the American Society of Anesthesiologist score.


CONCLUSIONS
The complications of laparoscopic urologic surgeries are strongly correlated with the operative difficulties. In spite of elevated complication rates in difficult surgeries, the major complication rate in this study was very low. As the laparoscopic surgeries in urology involve more and more technique-dependent difficult fields, documentation and analysis of experience of complications is important for the development of this surgical modality.
Division of Urology, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Yu-Hung
YH
Lin
Hsiao-Jen
HJ
Chung
Alex T L
AT
Lin
Yen-Hwa
YH
Chang
William J S
WJ
Huang
Yen-Shen
YS
Hsu
Shyh-Chyi
SC
Chang
Kuang-Kuo
KK
Chen
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D013520:Urologic Surgical Procedures / Q000009:adverse effects*