단일 술자에서 시행한 후복막강경수술의 합병증

Abstract

Purpose: Laparoscopic surgery is known to be safe and to have low morbidity. We evaluated all the complications of retroperitoneal laparoscopic procedures. Materials and Methods: A total of 120 retroperitoneal laparoscopic surgeries were performed from January 2002 to December 2005. Every abnormal event was investigated retrospectively and classified in detail according to surgical steps and severity. Results: Complication ratio (a total of complications/a total of surgeries) was 0.38 (46/120). Open conversion was done in 4.2%. 8 patients (6.7%) had transfusion. 5 patients (4.2%) had neuromuscular problem related to position. 9 patients (7.5%) had access and insufflation related complications including subcutaneous emphysema, abdominal wall hemorrhage, pneumothorax, and pneumomediastinum. Intraoperative complications (5.8%) included peritoneal tearing, vascular injury, and diaphragmatic injury. Postoperative complications occurred in 25 patients (20.8%); pleural effusion, atelectasis/pulmonary infiltrate, wound dehiscence, paralytic ileus, retroperitoneal hematoma, and urine leakage. 5 complications (4.2%) were classified into major complications; main vascular injury (1.7%), urine leakage (1.7%), and diaphragmatic injury (0.8%). No serious complications such as death, bowel injury, deep vein thrombosis with pulmonary embolism, and gas embolism occurred. Other complications (41/46) were minor and managed conservatively without any problem. Conclusions: The most common complications of retroperitoneal laparosocpic surgery seem to occur during postoperative period and be nonspecific to retroperitoneoscopy. Most complications are subclinical problems and able to be managed by conservative treatment. Retroperitoneal laparoscopic surgery is a safe procedure with low potential for complications.