Prospective evaluation of complications in laparoscopic urology at a mid-volume institution using standardized criteria: Experience of 1023 cases including learning curve in 9 years

Şanlı, Öner; Tefik, Tzevat; Erdem, Selçuk; Ortaç, Mazhar; Salabaş, Emre; Karakus, Serkan; Yucel, Baris; Böyük, Abubekir; Oktar, Tayfun; Özcan, Faruk; Aras, Necdet; Tunç, Murat; Nane, I.

doi:10.4103/0972-9941.158154

Cited by 6 publications

(9 citation statements)

References 31 publications

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“…The overall complication rate (13.4%) was within accepted international standards that were performed in single or multi-institutional settings. [ 4 6 12 13 14 15 ] The increasing experience that developed by a single surgeon in this study showed a significant reduction in the incidence of complications with experience. The complication rate was 19.8% during the first 4 years of the study.…”

Section: Discussionmentioning

confidence: 73%

Complications of 411 laparoscopic urological procedures: A single surgeon experience

Al-Otaibi

2018

Urol Ann

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Objectives:The aim of this study is to review the complications of laparoscopic urological procedures performed using a single surgeon during a 12-year period.Materials and Methods:From June 2004 to May 2017, a total of 411 abdominal urological procedures were performed using the author. They included 250 varicocele ligations, 94 nephrectomies (simple, partial, radical, and nephroureterectomy), 34 adrenalectomies, 22 renal cyst ablation, and 11 pelvic lymph node dissections. Operative and postoperative complications were reviewed and analyzed. The results were analyzed using Chi-squared tests for statistical analysis.Results:A total of 55 complications out of 411 procedures occurred in 26 patients with a total complication rate of 13.4%, 19 were major (4.6%), and 36 were minor (8.8%). Mortality occurred in two patients (0.5%). Conversion to open surgery was done in 5 patients (1.2%) to manage uncontrolled bleeding. Major intraoperative complications included vascular injuries (2.2%), injuries to the diaphragm (0.5%), bowel (0.7%), and pancreas (0.5%). Major postoperative complications included urine leak (0.2%) and pelvic lymphocele (0.2%). Minor intraoperative complications included bleeding during trocar access (4.4%) and subcutaneous emphysema (0.7%), whereas minor postoperative complications included atelectasis (1.2%) and ileus (2.2%).Conclusions:Even though the complications rate in this series was comparable to those of other studies in the literature, yet it remains higher than that of open surgery. The continuing advances in laparoscopic techniques will reduce the complication rate and will pave the way for laparoscopy to replace most currently practiced open surgical urological procedures.

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Section: Discussionmentioning

confidence: 73%

Complications of 411 laparoscopic urological procedures: A single surgeon experience

Al-Otaibi

2018

Urol Ann

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“…Other authors also report that transoperative bleeding is more frequently associated with nephrectomy because of lithiasis and renal tumor, nephroureterectomy and tumorectomy; results that coincide with this study. (18,20) Infectious complications were the most frequent, fever without focalization prevailed which was treated with antibiotic therapy in 17 (3.9%) patients and two (0.5%) with general measures. Liapis et al (15) (15) report two retroperitoneal abscesses drained surgically.…”

Section: Discussionmentioning

confidence: 99%

“…(3,9,15) In this study, grade II complications prevailed, as in other investigations that report a prevalence of minor complications (grade I, II). (3,15,20) Al-Otaibi et al (18) reported two grade V (0.48%) complications, one as the result of the perforation of the duodenum complicated with septic shock and another due to pulmonary thromboembolism. Sanli et al (20) deaths (0.49%).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic retroperitoneal approach for urinary tract surgery. Predictive factors of complications and conversion to open surgery

et al. 2022

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Introduction: Surgery by lumboscopic approach is of choice for some work groups, despite being more arduous and requiring a higher learning curve. Objective: To assess the lumboscopic approach and identify predictive factors of complications and conversion to open surgery. Material and Methods: A transversal, retrospective study of 436 patients that underwent surgery by lumboscopy at the National Center for Minimally Invasive Surgery, 2008-2019. Absolute and relative frequencies; the Chi-Square Test and Student´s t Test and the Multiple Logistics Regression, were utilized, (p≤0.05). Results: Renal atrophy due to benign diseases (49.8%), renoureteral lithiasis (26.6%), surgery of moderate complexity (71.9%) prevailed, such as nephrectomy (50.2%). 16.1% had undergone prior surgery, and 12.4% a urinary derivation. 3% required conversion to open surgery and 18.8% presented complications. Renal staghorn and non-staghorn lithiasis, surgical technique, level of complexity of the surgery, operative time, transoperative bleeding and length of hospital stay were significantly associated (p<0.05) to complications, but after measuring logistics regression, only hospital stay resulted statistically significant (p=0.000). Regarding conversion: gender, past history of prior surgery, operative time and bleeding were significantly associated (p<0.05) in both the univariate and multivariate analysis. Conclusions: Nephrectomy due to benign causes and surgeries of moderate complexity prevailed in this series. The perioperative outcomes were satisfactory and the most frequent complications were postoperative, infectious and of grade II severity. Longer hospital stay was a predictive factor for complications whereas males, past history of prior surgery, longer operative time and bleeding were identified as predictive factors for conversion to open surgery.

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“…Many complications have been published in the urology field since the definition of laparoscopic surgery. Complications of laparoscopic urological procedures rates are variable and were given in the literature from 4.4% to 23.1% [6][7][8][9][10][11][12][13][14][15][16]. In their early laparoscopic experience, Parra et al [5] reported their rate of complications 15%.…”

Section: Discussionmentioning

confidence: 99%

Complications of upper urinary system laparoscopic surgery: a single center experience with 942 cases

Ekşi

Şahin

Şener

et al. 2021

The European Research Journal

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Objectives: Since the introduction of laparoscopic nephrectomies, laparoscopic surgeries in the field of urology have become increasingly popular. Laparoscopic surgery has its advantages but carries the risk of complications like all interventions. In our study, we aimed to discuss our complication rates according to difficulty level by presenting our experiences with urological laparoscopic procedures for the upper urinary system. Methods: This retrospective study includes 942 laparoscopic urological procedures performed by a single surgeon. The procedures divided into three groups according to the European Scoring System (ESS) Classification. The complication rate of each group was calculated separately. Results: A total of 127 (13.4%) complications were observed. Partial nephrectomy, nephroureterectomy and ureterolithotomy had the highest complication rates. Renal cyst excision, simple nephrectomy and radical nephrectomy had the lowest complication rates. According to the Clavien Complication Classification, the distributions of Grade 1, 2 and 3 complications were 29.1% (n =37), 57.4% (n = 73) and 13.3% (n = 17); respectively. The open conversion rate was 0.84%. When procedures were classified as "easy", "difficult" and "very difficult" according to the ESS classification; complication rates were found 7.3% in the easy group, 13.3% in the difficult group and 16.6% in the very difficult group. There was no significant difference between the three groups in terms of complication rates (p = 0.329). Conclusions: Performing easier operations according to ESS in the first years of the learning curve is beneficial in preventing complications. With increasing experience, more complicated procedures can be performed with similar complication rates.

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Prospective evaluation of complications in laparoscopic urology at a mid-volume institution using standardized criteria: Experience of 1023 cases including learning curve in 9 years

Cited by 6 publications

References 31 publications

Complications of 411 laparoscopic urological procedures: A single surgeon experience

Complications of 411 laparoscopic urological procedures: A single surgeon experience

Laparoscopic retroperitoneal approach for urinary tract surgery. Predictive factors of complications and conversion to open surgery

Complications of upper urinary system laparoscopic surgery: a single center experience with 942 cases

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