The Clinical Analysis In Complications Of Gynaecology Laparoscope

Objective: This study is to investigate the classfication, incidence, and causes ofcomplications of gynecological laparoscopy operations. The clinical manifestationsand measures of prevention and treatment will be mastered to raise the operation safetyand reduce complications and its serious consequences.Methods: A statistics was carried out based on clinical of2889cases of gynecologicallaparoscopy operations from January1,2006to December31,2012in YijishanHospital affiliated to Wannan Medical College, in order to summary46cases ofcomplication related causes and prevention measures.Results: First, A retrospective analysis was done based on clinical data of2889casesof gynecological laparoscopy operations from January1,2006to December31,2012in Yijishan Hospital affiliated to Wannan Medical College. The number ofcomplications of gynecological laparoscopy operations is46, with a incidence of1.59%, which is similar with that reported in literature. These operations include twocases that need conversion to open laparotomy. The rest cases were cured after theconservative treatment was executed, and none of patient died. Second, the incidenceof laparoscopy complications declines generally from2006to2012in the hospital,with a peak value of6.06%in2006and a minimum value of0.52%in2012.Laparoscopic complications happened in adnexal operations (â… ,â…¡ kind of surgery) in2006, but occurred in myomectomy and hysterectomy (â…¢ kind of surgery) from2006to2007. From2010to2012, the laparoscopic complications occurred predominantly inhysterectomy (â…¢ kind of surgery) and malignant tumors (â…£ kind of surgery). Third,compared with the incidence of laparoscopy complications in former three years, incidence in later four years was significantly decreased with p value <0.05, which hasstatistical significance. Fourth, The surgical difference between adnexal operations andother operations was statistically significant. The occurrence rates of complicationsbetween myomectomy and hysterectomy were no difference. There was a statisticallysignificant difference in complication rate between malignant tumor with other groups.Surgical complications incidences are statistically significant differences among thesefour laparoscopic surgical groups. Fifth, in the46complications cases of gynecologicallaparoscopy operations, it includes2cases of subcutaneous emphysema,4cases ofabdominal wall,4cases of hemorrhage,1case of ureteral injuries,2cases ofconversion to laparotomy,1case of sustained ectopic pregnancy,11cases ofpostoperative infection,6cases of residual poor healing,3cases of incision healingdelay,6cases of gastroenteritis,1case of incomplete intestinal obstruction,1case ofneural paralysis,1case of double eye muscle spasm,1case of bladder injury,1case ofinfection with hematoma near the uterus,1case of episiohematoma.Conclusions: First, the incidence of the laparoscopic complications in YijishanHospital was1.59%from January2006to December2012, similar with the incidencereported in literature.Second, the incidence of laparoscopic surgery complications overall declinesduring2006-2012. Compared with the incidence of laparoscopy complications informer three years, incidence in later four years was significantly decreased, which isrelated to the continuously improvement of laparoscopic technical skill and theprevention measures in the hospital.Third, the incidence of laparoscopic surgery complications is related withoperation difficulty closely. When the difficulty of the operation increases, theincidence of complication rose. The incidences of laparoscopic surgery complicationsincrease from the simple â… and â…¡ kind of operations to the complex â…¢ and â…£kind of operations. Since2008, the complications incidences of the â…£ kind of operations rose after the malignant tumor operation had been carried in the YijishanHospital.Fourth, laparoscopic surgery complications was no close correlation withoperative history.Fifth, prevention measures of laparoscopic surgery complications include thefollowing aspects:1. Strictly insight into laparoscopic surgical indications is thepremise condition to reduce complications.2. Improving surgical technique skills,understanding the performance of the instrument and undertaking normal operationtraining is the key factors to reduce of complications.3. It is the important measurethat transferred the operation to laparotomy in time to reduce complications in theprocess of intraoperative difficult operation.4.It is important to master thecharacteristics, regularity, prevention and control methods of laparoscopiccomplications, take close observation to the situation and the complaint ofpostoperative patients, and discover and manage the complications timely.