Complications of abdominal urologic laparoscopy: Longitudinal five-year analysis

J. Kellogg Parsons, Ioannis Varkarakis, KoonHo Rha, Thomas W. Jarrett, Peter A. Pinto, Louis R. Kavoussi

Research output: Contribution to journalArticle

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Abstract

Objectives. To analyze complications of abdominal laparoscopic surgery of the urinary tract at a single institution during a 5-year period. Methods. From 1996 to 2000, we identified 894 abdominal laparoscopic procedures performed at a single institution: 600 nephrectomies (live donor, simple, radical, nephroureterectomy, and partial), 112 pyeloplasties, 61 renal biopsies, 35 retroperitoneal lymph node dissections, 31 renal cyst ablations, 18 adrenalectomies, and 37 other abdominal procedures. The charts were retrospectively reviewed for complications, which were classified as operative, postoperative, or medical. Complications were correlated with patient age and American Society of Anesthesiologists score. Statistical analysis was performed with Fisher's exact test and chi-square tests. Results. A total of 118 complications (13.2%) occurred. Two patients (0.2%) died. As a result of operative complications, the procedure of 13 patients (1.5%) was converted to an open one. As a result of postoperative complications, 13 (1.5%) underwent operative and 6 (0.7%) nonoperative intervention. The most common intraoperative complications were vascular (n = 23), adjacent organ (n = 10), and bowel (n = 9) injuries. The most common postoperative complications were neuromuscular pain (n = 12), hematoma (n = 11), urine leak (n = 7), and wound infection (n = 7). The differences in the annual complication rates for all procedures did not attain statistical significance (P = 0.5). Among all procedures, excluding live donor nephrectomy, complications of any kind correlated with a greater patient American Society of Anesthesiologists score (P = 0.01). Conclusions. Rather than decreasing, the overall incidence of laparoscopic complications did not change significantly during a 5-year period at our institution. The factors contributing to this observation likely included the progression of inexperienced individual surgeons through the learning curve, the introduction of new, more sophisticated laparoscopic procedures, and stable rates of patient comorbidity. This experience may represent the average complication rate for urologic laparoscopy at a large-volume, academic training center.

Original languageEnglish
Pages (from-to)27-32
Number of pages6
JournalUrology
Volume63
Issue number1
DOIs
Publication statusPublished - 2004 Jan 1

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Laparoscopy
Nephrectomy
Tissue Donors
Kidney
Learning Curve
Adrenalectomy
Intraoperative Complications
Operative Surgical Procedures
Wound Infection
Chi-Square Distribution
Lymph Node Excision
Urinary Tract
Hematoma
Blood Vessels
Comorbidity
Cysts
Teaching
Urine
Biopsy
Pain

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Parsons, J. K., Varkarakis, I., Rha, K., Jarrett, T. W., Pinto, P. A., & Kavoussi, L. R. (2004). Complications of abdominal urologic laparoscopy: Longitudinal five-year analysis. Urology, 63(1), 27-32. https://doi.org/10.1016/j.urology.2003.10.003
Parsons, J. Kellogg ; Varkarakis, Ioannis ; Rha, KoonHo ; Jarrett, Thomas W. ; Pinto, Peter A. ; Kavoussi, Louis R. / Complications of abdominal urologic laparoscopy : Longitudinal five-year analysis. In: Urology. 2004 ; Vol. 63, No. 1. pp. 27-32.
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Parsons, JK, Varkarakis, I, Rha, K, Jarrett, TW, Pinto, PA & Kavoussi, LR 2004, 'Complications of abdominal urologic laparoscopy: Longitudinal five-year analysis', Urology, vol. 63, no. 1, pp. 27-32. https://doi.org/10.1016/j.urology.2003.10.003

Complications of abdominal urologic laparoscopy : Longitudinal five-year analysis. / Parsons, J. Kellogg; Varkarakis, Ioannis; Rha, KoonHo; Jarrett, Thomas W.; Pinto, Peter A.; Kavoussi, Louis R.

In: Urology, Vol. 63, No. 1, 01.01.2004, p. 27-32.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Complications of abdominal urologic laparoscopy

T2 - Longitudinal five-year analysis

AU - Parsons, J. Kellogg

AU - Varkarakis, Ioannis

AU - Rha, KoonHo

AU - Jarrett, Thomas W.

AU - Pinto, Peter A.

AU - Kavoussi, Louis R.

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N2 - Objectives. To analyze complications of abdominal laparoscopic surgery of the urinary tract at a single institution during a 5-year period. Methods. From 1996 to 2000, we identified 894 abdominal laparoscopic procedures performed at a single institution: 600 nephrectomies (live donor, simple, radical, nephroureterectomy, and partial), 112 pyeloplasties, 61 renal biopsies, 35 retroperitoneal lymph node dissections, 31 renal cyst ablations, 18 adrenalectomies, and 37 other abdominal procedures. The charts were retrospectively reviewed for complications, which were classified as operative, postoperative, or medical. Complications were correlated with patient age and American Society of Anesthesiologists score. Statistical analysis was performed with Fisher's exact test and chi-square tests. Results. A total of 118 complications (13.2%) occurred. Two patients (0.2%) died. As a result of operative complications, the procedure of 13 patients (1.5%) was converted to an open one. As a result of postoperative complications, 13 (1.5%) underwent operative and 6 (0.7%) nonoperative intervention. The most common intraoperative complications were vascular (n = 23), adjacent organ (n = 10), and bowel (n = 9) injuries. The most common postoperative complications were neuromuscular pain (n = 12), hematoma (n = 11), urine leak (n = 7), and wound infection (n = 7). The differences in the annual complication rates for all procedures did not attain statistical significance (P = 0.5). Among all procedures, excluding live donor nephrectomy, complications of any kind correlated with a greater patient American Society of Anesthesiologists score (P = 0.01). Conclusions. Rather than decreasing, the overall incidence of laparoscopic complications did not change significantly during a 5-year period at our institution. The factors contributing to this observation likely included the progression of inexperienced individual surgeons through the learning curve, the introduction of new, more sophisticated laparoscopic procedures, and stable rates of patient comorbidity. This experience may represent the average complication rate for urologic laparoscopy at a large-volume, academic training center.

AB - Objectives. To analyze complications of abdominal laparoscopic surgery of the urinary tract at a single institution during a 5-year period. Methods. From 1996 to 2000, we identified 894 abdominal laparoscopic procedures performed at a single institution: 600 nephrectomies (live donor, simple, radical, nephroureterectomy, and partial), 112 pyeloplasties, 61 renal biopsies, 35 retroperitoneal lymph node dissections, 31 renal cyst ablations, 18 adrenalectomies, and 37 other abdominal procedures. The charts were retrospectively reviewed for complications, which were classified as operative, postoperative, or medical. Complications were correlated with patient age and American Society of Anesthesiologists score. Statistical analysis was performed with Fisher's exact test and chi-square tests. Results. A total of 118 complications (13.2%) occurred. Two patients (0.2%) died. As a result of operative complications, the procedure of 13 patients (1.5%) was converted to an open one. As a result of postoperative complications, 13 (1.5%) underwent operative and 6 (0.7%) nonoperative intervention. The most common intraoperative complications were vascular (n = 23), adjacent organ (n = 10), and bowel (n = 9) injuries. The most common postoperative complications were neuromuscular pain (n = 12), hematoma (n = 11), urine leak (n = 7), and wound infection (n = 7). The differences in the annual complication rates for all procedures did not attain statistical significance (P = 0.5). Among all procedures, excluding live donor nephrectomy, complications of any kind correlated with a greater patient American Society of Anesthesiologists score (P = 0.01). Conclusions. Rather than decreasing, the overall incidence of laparoscopic complications did not change significantly during a 5-year period at our institution. The factors contributing to this observation likely included the progression of inexperienced individual surgeons through the learning curve, the introduction of new, more sophisticated laparoscopic procedures, and stable rates of patient comorbidity. This experience may represent the average complication rate for urologic laparoscopy at a large-volume, academic training center.

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