泌尿外科后腹腔镜手术并发症的预防和处理

目的:分析泌尿外科后腹腔镜手术并发症发生的原因以及预防和处理对策。方法:总结采用后腹腔镜技术治疗泌尿系疾病发生的各种并发症,对术中并发症原因进行分析。结果:162例手术共出现较严重并发症6例,占3.70%,包括损伤血管2例、损伤胸膜2例、误夹肾动脉1例、严重的高碳酸血症和酸中毒1例;其他轻度并发症14例,包括腹膜损伤6例、切口感染1例、皮下气肿7例;无一例中转开放手术。所有患者术后完全康复出院。结论:后腹腔镜手术存在发生严重并发症的可能,需通过提高技术、熟悉解剖关系和总结经验来避免。严格控制后腹腔镜手术的适应证,操作经验的积累会明显减少并发症发生。

The prevention and treatment of complications of retroperitoneoscopic technique in urology

Objective:To analyze the causes of complications of retroperitoneoscopic technique in urology and the prevention approaches.Methods:Complications of retroperitoneoscopic technique applying in urology in our hospital between January 2002 and July 2006 were analysed.Results:There were 6 cases of patients with serious complications in this group (3.70%), they were vessel trauma (2 case), pleura trauma (2 case), serious hypercarbia and acidosis (1 case),clip renal artery by mistake(1 case), Other mild complications included peritoneum trauma (6 cases), incision infection (1 case), pneumoderma (7 cases). No one needed transfer to open surgery. Conclusions:Some serious complications may happen in retroperitoneoscopic surgery. It is necessary to improve this technique, master the anatomic relation and summarize the experience to reduce the complications.