妇科腹腔镜手术并发症及中转开腹危险因素分析

摘要

Objective To explore the reasons for complications and conversion to lapaotomy in gynecological laparoscopic operation. Methods The clinical data of 1281 patients with laparoscopy operations in our hospital from December, 2010 to December, 2013 were studied retrospectively. We observed the cases that complications and conversion to lapaotomy happened and analyzed the reasons.ResultsThe overall complication rate was 1.63% (21/1281), in which the Ⅰclass surgical complication rate was 0.12%, Ⅱ class surgical complication rate was 0.46%, Ⅲ class surgical has the same incidence rate with the Ⅱ class surgical (0.46%) and Ⅳ types of surgery occurred at rate of 0.63% . There are totally 13 cases of laparotomy with laparotomy probability of 1.01%, which mainly ascribe to: pelvic adhesions, special parts of uterine fibroids, excessive number of uterine fibroids, ovarian cancer, close to organ damage.ConclusionStrengthening the preoperative evaluation to improve laparoscopic surgical skills, being familiar with pelvic anatomy as well as having extensive experience in open surgery laparoscopic surgery all can reduce the incidence of complications and laparotomy.%目的：探讨妇科腹腔镜手术并发症及中转开腹的原因。方法对我院2010年12月～2013年12月的1281例腹腔镜手术进行回顾性分析，观察手术并发症的发生及中转开腹的原因。结果总体并发症发生率为1.63%（21/1281），其中Ⅰ类手术并发症发生率为0.12%，Ⅱ类手术并发症发生率为0.46%，Ⅲ类手术发生率为0.46%，Ⅳ类手术发生率为0.63%。共有13例中转开腹，中转开腹概率为1.01%，主要原因为：盆腔粘连、特殊部位子宫肌瘤、子宫肌瘤数目过多、卵巢恶性肿瘤、临近脏器损伤等。结论加强术前评估，提高腹腔镜手术技巧，熟悉盆腔解剖，有丰富的开腹手术经验都可以降低腹腔镜手术并发症及中转开腹的发生。