妇科腹腔镜手术3993例并发症分析

目的探讨妇科腹腔镜手术并发症的相关情况,寻求有效预防和减少并发症的方法,降低并发症危害。方法对首都医科大学附属北京朝阳医院妇科1995年2月至2008年12月3993例腹腔镜手术术中及术后并发症的发生情况进行回顾性分析。结果 3993例妇科腹腔镜手术中,并发症发生率为1.65%(66/3993),其中轻度并发症41例,发生率为1.03%;重度并发症25例,发生率为0.63%。手术并发症与医师的手术经验明显相关,从事腹腔镜手术时间不足1年者,并发症发生率明显升高,尤其是与穿刺及气腹有关的并发症;手术并发症与腹部手术史有相关性,有腹部手术史患者并发症发生率较无手术史者增高。结论腹腔镜手术并发症与手术难度、腹部手术史及医师手术经验有关。提高临床医生的内镜手术技能和手术技巧,进行正规手术操作训练可减少并发症的发生。

A comprehensive analysis of the complications in 3993 cases laparoscopic gynecological surgeries

ObjectiveTo investigate the related surgical complications with gynecologic laparoscopy,to effectively prevent and decrease complications so as to reduce the hazard of complications.MethodsRetrospective analysis was carried on for 3993 cases with laparoscopic surgery and 39 cases with surgical complications in Gynecology Department of Chaoyang Hospital of Capital University of Medical Sciences between February 1995 and December 2008.ResultsThe complication rate was 0.98% among 3993 cases with gynecologic laparoscopic surgery.There were 41 minor complication and 25 major complication cases,the incidence rate was1.03 and 0.63%.There were significantly negative correlation between doctor’s experience and complication rate.The highest complication rate was observed among doctors who had laparoscopic experience of less than 1 year.There were differences of complication rate in women with or without history of laparotomy.ConclusionLaparoscopic surgery-related complications was relative with the operative difficulties,history of abdominal surgery and surgical experience.Complications could be reduced through improving the skills and techniques and proper training in endoscopic surgery.