An analysis of general surgery-related complications in a series of 412 minilaparotomic anterior lumbosacral procedures.
OBJECTIVE
Anterior lumbar surgery is associated with certain perioperative visceral and vascular complications. The aim of this study was to document all general surgery-related adverse events and complications following minilaparotomic retroperitoneal lumbar procedures and to discuss strategies for their management or prevention.


METHODS
The authors analyzed data obtained in 412 patients who underwent anterior lumbosacral surgery between 2003 and 2005. The series comprised 114 men and 298 women whose mean age was 56 years (range 34-79 years). Preoperative diagnoses were as follows: isthmic spondylolisthesis (32%), degenerative spondylolisthesis (24%), instability/stenosis (15%), degenerative disc disease (15%), failed-back surgery syndrome (7%), and lumbar degenerative kyphosis or scoliosis (7%). A single level was exposed in 264 patients (64%), 2 in 118 (29%), and 3 or 4 in 30 (7%). The average follow-up period was 16 months.


RESULTS
Overall, 52 instances of complications and adverse events occurred in 50 patients (12.1%), including sympathetic dysfunction in 25 (6.06%), vascular injury repaired with/without direct suture in 12 (2.9%), ileus lasting > 3 days in 5 (1.2%), pleural effusion in 4 (0.97%), wound dehiscence in 2 (0.49%), symptomatic retroperitoneal hematoma in 2 (0.49%), angina in 1 (0.24%), and bowel laceration in 1 patient (0.24%). There was no instance of retrograde ejaculation in male patients, and most complications had no long-term sequelae.


CONCLUSIONS
This report presents a detailed analysis of complications related to anterior lumbar surgery. Although the incidence of complications appears low considering the magnitude of the procedure, surgeons should be aware of these potential complications and their management.
Kang
Byung-Uk
BU
Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea. grussin@dreamwiz.com
Choi
Won-Chul
WC
Lee
Sang-Ho
SH
Jeon
Sang Hyeop
SH
Park
Jong Dae
JD
Maeng
Dae Hyeon
DH
Choi
Young-Geun
YG
D000328:Adult; D000368:Aged; D001808:Blood Vessels / Q000293:injuries; D016208:Databases, Factual; D005260:Female; D013502:General Surgery / Q000706:statistics & numerical data; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012447:Sacrum / Q000601:surgery; D013122:Spinal Diseases / Q000453:epidemiology* / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000706:statistics & numerical data; D013564:Sympathetic Nervous System / Q000293:injuries