Analysis of operation-related complications of totally laparoscopic aortoiliac surgery.
BACKGROUND
Totally laparoscopic aortoiliac surgery has been newly developed in China. It is known as the most complex laparoscopic technique to learn because of its high-risk procedures. Analysis of the operation-related complications of this surgery is supposed to be helpful for the early success of this technique.


METHODS
Twelve male patients (56-70 years old) with aortoiliac occlusive disease underwent totally laparoscopic aortoiliac bypass surgery (TLABS) in our institute. Clinical data and operation-related complications were retrospectively analyzed.


RESULTS
Of the 12 patients, TLABS succeeded in nine and conversion to open surgery occurred in three. One of the converted patients finally died of pulmonary infection. Operation-related complications included bleeding from arterial injury, perforation from colonic injury, graft embolism, residual aortic stenosis, and hydronephrosis. Bleeding in two patients and colonic perforation in one patient resulted in three conversions to open surgery. Intraoperative graft embolectomy and postoperative aortic stenting were performed to resolve the thrombus/embolus-referring complications. Left hydronephrosis, which was thought to result from intraoperative injury and treated with ureteric intubation drainage, recovered 6 months after TLABS.


CONCLUSIONS
Good understanding and avoidance of operation-related complications are important to guarantee the technical success of TLABS. Immediate conversion to open surgery is necessary for saving the patient's life in case of life-threatening complications.
Department of Vascular Surgery, Xuanwu Hospital; Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China.
Lixing
L
Qi
Department of Vascular Surgery, Xuanwu Hospital; Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China. Email: yq-gu@263.net.
Yongquan
Y
Gu
Department of Vascular Surgery, Xuanwu Hospital; Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China.
Lianrui
L
Guo
Department of Vascular Surgery, Xuanwu Hospital; Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China.
Xuefeng
X
Li
Department of Vascular Surgery, Xuanwu Hospital; Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China.
Yingfeng
Y
Wu
Department of Vascular Surgery, Xuanwu Hospital; Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China.
Shijun
S
Cui
Department of Vascular Surgery, Xuanwu Hospital; Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China.
Zhu
Z
Tong
Department of Vascular Surgery, Xuanwu Hospital; Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China.
Xin
X
Wu
Department of Vascular Surgery, Xuanwu Hospital; Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China.
Jianming
J
Guo
Department of Vascular Surgery, Xuanwu Hospital; Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China.
Jian
J
Zhang
Department of Vascular Surgery, Xuanwu Hospital; Institute of Vascular Surgery, Capital Medical University, Beijing 100053, China.
Zhonggao
Z
Wang
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome