Document Detail


Morbidity in laparoscopic gynecological surgery: results of a prospective single-center study.
MedLine Citation:
PMID:  9869690     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We set out to investigate prospectively the morbidity rate for gynecological laparoscopy patients at a tertiary care center. METHODS: We prospectively recorded data on 743 laparoscopic procedures performed between January 1, 1992 and December 31, 1996. The procedures included 36 diagnostic laparoscopies (4.8%), 115 laparoscopies carried out for minor surgical acts (15.4%), 523 for major surgical acts (70.4%), and 69 for advanced surgical acts (9. 4%). A total of 127 patients had a history of prior laparotomy (17%). All those procedures were performed by young senior surgeons. We defined a complication as an event that had modified the usual course of the procedure or of the postoperative period. For statistical analysis, we used the chi-squared test or Fisher's exact test. RESULTS: Complications occurred in 22 cases; the overall complication rate was 2.9% when all events were considered. One complication (injury of the left primitive iliac artery) was related to insertion of the Veress needle (0.13%). A total of 2,578 trocars were inserted, giving rise to 10 complications (1.3%). Three unintended laparotomies were required for bowel or bladder injuries (0.4%). Finally, the introduction of the laparoscope was responsible for 11 complications (1.4%); this figure represents 50% of all the complications of this series. Eight intraoperative complications (1%) occurred during the laparoscopic surgery (seven severe bleedings and one ureter injury, but no intestinal lesions); laparotomy was required in six of these cases. Three complications occurred during the postoperative stage: one granulomatous peritonitis after intraabdominal rupture of a dermoid cyst, one incisional hernia, and a fast-resolving cardiac arrhythmia. CONCLUSIONS: In our experience, operative gynecological laparoscopy is associated with an acceptable morbidity rate. Moreover, about half of the complications occur during the installation of the laparoscopic procedure, underscoring the usefulness of safety rules.
Authors:
C Mac Cordick; F Lécuru; E Rizk; F Robin; V Boucaya; R Taurelle
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Surgical endoscopy     Volume:  13     ISSN:  0930-2794     ISO Abbreviation:  Surg Endosc     Publication Date:  1999 Jan 
Date Detail:
Created Date:  1999-02-18     Completed Date:  1999-02-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  57-61     Citation Subset:  IM    
Affiliation:
Service de Gynécologie-Obstétrique, Hôpital Boucicaut, 78 rue de la Convention, 75015 Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Chi-Square Distribution
Evaluation Studies as Topic
Female
Genital Diseases, Female / diagnosis,  surgery*
Humans
Incidence
Intraoperative Complications / epidemiology*,  etiology
Laparoscopy / adverse effects*,  methods
Morbidity / trends
Postoperative Complications / epidemiology*,  etiology
Prognosis
Prospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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