Complications of Retroperitoneal Laparoscopic Surgery / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Laparoscopic surgery is known to be safe and have low morbidity. Herein, all the complications of retroperitoneal laparoscopic procedures were evaluated. MATERIALS AND METHODS: A total of 120 retroperitoneal laparoscopic surgeries were performed between January 2002 and December 2005. Every abnormal event was investigated retrospectively, and classified in detail according to the surgical steps and severity. RESULTS: The complication ratio (total complications/total surgeries) was 0.38 (46/120). Open conversion was performed in 5 (4.2%). A transfusion was performed in 8 (6.7%) patients. 5 patients (4.2%) had neuromuscular problem related to position and 9 (7.5%) had access and insufflation related complications, including subcutaneous emphysema, abdominal wall hemorrhage, pneumothorax and pneumomediastinum. The intraoperative complications (5.8%) included peritoneal tearing, vascular injury and diaphragmatic injury. Postoperative complications occurred in 25 patients (20.8%), including pleural effusion, atelectasis/pulmonary infiltrate, wound dehiscence, paralytic ileus, retroperitoneal hematoma and urine leakage. 5 complications (4.2%) were classified as being major; 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, or gas embolism occurred. Other complications (41/46) were minor and managed conservatively, without any problem. CONCLUSIONS: The most common complications of retroperitoneal laparoscopic surgery seem to occur during the postoperative period, and are nonspecific to retroperitoneoscopy. Most complications are subclinical problems, which can be managed by conservative treatment. Retroperitoneal laparoscopic surgery is a safe procedure, with a low potential for complications.