[Complications of retroperitoneal laparoscopy based on a series of 500 cases].

Abstract

OBJECTIVE:

To evaluate the complications of retroperitoneal laparoscopy for upper urinary tract surgery.

METHODS:

From 1994 to 2003, 500 retroperitoneal laparoscopy procedures were performed: 143 radical nephrectomies, 104 simple nephrectomies, 95 adrenalectomies, 47 ureteropelvic junction plasties, 44 partial nephrectomies, 22 nephroureterectomies, 20 cyst resections, 9 diverticulectomies, 8 lymphadenectomies, 4 pyelotomies and 4 ureteric procedures. The standardized technique uses 5 trocars.

RESULTS:

There were 23 conversions (4.60%): 5 for retroperitoneal adhesions, 11 for intraoperative bleeding, 7 for technical impossibility. 14 patients (2.8%) required surgical revision: 5 urinomas and 2 urocutaneous fistulas treated by ureteric drainage, 2 deep abscesses, 2 cases of secondary bleeding, 2 colostomies for gastrointestinal fistula after colonic injury, 1 incisional hernia on a trocar orifice. There were postoperative 2 deaths (0.4%) due to septic shock and haemorrhagic shock. 21 patients (4.2%) presented medical postoperative complications: haematoma, hyperthermia, phlebitis and pulmonary infections. 15 patients (3%) were transfused. The most frequent complications occurred after partial nephrectomies and the most serious complications occurred after radical nephrectomies.

CONCLUSION:

The complication rate is low. Retroperitoneal laparoscopy allows reproducible and effective upper urinary tract surgery, but it is not recommended in patients with a history of retroperitoneal surgery.

• Authors: Alexis Demey, Alexandre de la Taille, Dimitri Vordos, Andras Hoznek, Dominique K Chopin, Claude-Clément Abbou, Laurent Salomon
• Journal: Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie (Prog Urol) Vol. 16 Issue 2 Pg. 128-33 (Apr 2006) ISSN: 1166-7087 [Print] France
• Vernacular Title: Complications de la laparoscopie rétropéritonéale: experience aprés 500 cas.
• PMID: 16734232 (Publication Type: English Abstract, Journal Article)

Topics

• Adrenalectomy (adverse effects, methods)
• Humans
• Laparoscopy (adverse effects)
• Nephrectomy (adverse effects, methods)
• Postoperative Complications (etiology)
• Ureter (surgery)