Retroperitoneal and pelvic extraperitoneal laparoscopy: An international perspective

被引:104
作者
Gill, IS [1 ]
Clayman, RV
Albala, DM
Aso, Y
Chiu, AW
Das, S
Donovan, JF
Fuchs, GJ
Gaur, DD
Go, H
Gomella, LG
Grune, MT
Harewood, LM
Janetschek, G
Knapp, PM
McDougall, EM
Nakada, SY
Preminger, GM
Puppo, P
Rassweiler, JJ
Royce, PL
Thomas, R
Urban, DA
Winfield, HN
机构
[1] Cleveland Clin Fdn, Dept Urol, Sect Laparoscop Surg, Desk A-100,9500 Euclid Ave, Cleveland, OH 44195 USA
[2] Univ Nebraska, Med Ctr, Omaha, NE USA
[3] Washington Univ, Sch Med, St Louis, MO USA
[4] Loyola Univ Med Ctr, Maywood, IL 60153 USA
[5] Fujieda Municipal Gen Hosp, Shizuoka, Japan
[6] Natl Yang Ming Univ, Sch Med, Taipei 112, Taiwan
[7] Kaiser Permanente Med Ctr, Walnut Creek, CA USA
[8] Univ Oklahoma, Med Ctr, Oklahoma City, OK USA
[9] Univ Calif Los Angeles, Los Angeles, CA USA
[10] Bombay Hosp & Med Res Ctr, Inst Med Sci, Bombay, Maharashtra, India
[11] Thomas Jefferson Med Coll, Philadelphia, PA USA
[12] Univ Melbourne, Royal Melbourne Hosp, Melbourne, Vic 3050, Australia
[13] Univ Innsbruck, A-6020 Innsbruck, Austria
[14] Indiana Univ, Indianapolis, IN 46204 USA
[15] Univ Wisconsin, Ctr Sci, Madison, WI USA
[16] Duke Univ, Med Ctr, Durham, NC USA
[17] Osped Gallieza Genoa, Genoa, Italy
[18] Urol Clin, Heilbronn, Germany
[19] Cabrini Med Ctr, Melbourne, Vic, Australia
[20] Tulane Univ, Sch Med, New Orleans, LA 70112 USA
[21] Univ Alabama Birmingham, Birmingham, AL USA
[22] Stanford Univ, Med Ctr, Palo Alto, CA 94304 USA
关键词
D O I
10.1016/S0090-4295(98)00314-8
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives. To assess technical preferences and current practice trends of retroperitoneal and pelvic extraperitoneal laparoscopy. Methods. A questionnaire survey of 36 selected urologic laparoscopic centers worldwide was performed. Results. Twenty-four centers (67%) responded. Overall, 3988 laparoscopic procedures were reported: transperitoneal approach (n = 2945) and retroperitoneal/extraperitoneal approach (n = 1043). Retroperitoneoscopic/extraperitoneoscopic procedures included adrenalectomy (n = 74), nephrectomy (n = 299), ureteral procedures (n = 166), pelvic lymph node dissection (n = 197), bladder neck suspension (n = 210), varix ligation (n = 91), and lumbar sympathectomy (n = 6). Mean number of total laparoscopic procedures performed in 1995 per center was 41 (range 5 to 86). Major complications occurred in 49 (4.7%) patients and included visceral complications in 26 (2.5%) patients and vascular complications in 23 (2.2%). Open conversion was performed in 69 (6.6%) patients, electively in 41 and emergently in 28 (visceral injuries, n = 16; vascular injuries, n = 12). Retroperitoneoscopy/extraperitoneoscopy is gaining in acceptance worldwide: in 1993, the mean estimated ratio of transperitoneal laparoscopic cases versus retroperitoneoscopic/ extraperitoneoscopic cases per center was 74:26; however, in 1996 the ratio was 49:51. Conclusions. Retroperitoneoscopy and pelvic extraperitoneoscopy are important adjuncts to the laparoscopic armamentarium in urologic surgery. The overall major complication rate associated with retroperitoneoscopy/extraperitoneoscopy was 4.7%. UROLOGY 52: 566-571, 1998. (C) 1998, Elsevier Science Inc. All rights reserved.
引用
收藏
页码:566 / 571
页数:6
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