Major complications of operative gynecologic laparoscopy in Southern Taiwan

A follow-up study

Yu Feng Tian, Yue Shan Lin, Chin Li Lu, Chun Chieh Chia, Kuo Feng Huang, Tune Yie Shih, Kun Hung Shen, Ming Ting Chung, Yung Chieh Tsai, Chien Hsun Chao, Ming Ping Wu

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Study objectives: This follow-up study examined the major complications among 4307 operative gynecologic laparoscopies. The overall complication rate and each individual category were compared with those of our previous study period. The clinical outcome and salvage procedures were correlated with the time of recognition and the severity of initial procedures in the individual injury type. Design: Retrospective, comparative study based on medical record reviewing (Canadian Task Force classification II-3). Setting: Tertiary teaching hospital, Chi Mei Foundation Hospital in southern Taiwan. Patients: Records of women (n = 4307) aged 40.5 ± 11.7 years (mean ± SD [95% CI 40.1-40.5]) who underwent operative gynecologic laparoscopies from January 2000 through February 2006 were reviewed in this study. The complications were compared with those of our previous study based on 1507 laparoscopies performed between December 1992 and November 1999 for follow-up comparison. Interventions: Gynecologic laparoscopic surgeries. Measurements and main results: Thirty-four complications occurred in 31 patients requiring repair procedures, 3 of whom had multiple complications, with an overall complication rate of 0.72% (31/4307). There were 13 bladder injuries (0.30%), 7 bowel injuries (0.16%), 3 cases of internal bleeding (0.07%), 4 vaginal stump hematomas or abscesses (0.09%), 3 ureteral injuries (0.07%), 3 major vessel injuries (0.07%), and 1 trocar site hematoma (0.02%). In addition, there were 125 (2.88%) postoperative blood transfusions without additional operative intervention. The major complication rate decreased compared with that of the previous study (0.72% [95% CI 0.51%-1.02%] vs 1.59% [95% CI 1.07%-2.36%]; p = .005). The overall complication rates were not significantly different between laparoscopic hysterectomy (LH) group and non-LH group. However, bladder injury happened more frequently in the LH group, whereas bowel injury was more common in the non-LH group. In addition, the severity of the original injury, timing of recognition, and accompanying salvage procedures correlated with the clinical outcomes. Conclusion: The significantly decreased major complication rate, as compared with that of our previous study period, confirms the importance of experience accumulation and use of preventive maneuvers in reducing the complication rate. There were no significant differences among the individual injury category during these 2 study periods. The manifestations of bowel injury were highly variable and individualized. The accumulation of surgical experience with the aid of preventive maneuvers is helpful to reduce the complication rate significantly.

Original languageEnglish
Pages (from-to)284-292
Number of pages9
JournalJournal of Minimally Invasive Gynecology
Volume14
Issue number3
DOIs
Publication statusPublished - May 2007

Fingerprint

Taiwan
Laparoscopy
Wounds and Injuries
Hysterectomy
Hematoma
Urinary Bladder
Gynecologic Surgical Procedures
Advisory Committees
Surgical Instruments
Tertiary Care Centers
Individuality
Teaching Hospitals
Blood Transfusion
Abscess
Medical Records
Retrospective Studies
Hemorrhage

Keywords

  • Bladder
  • Bowel
  • Complications
  • Laparoscopy
  • Major vessel injury
  • Ureteral
  • Vaginal stump hematoma

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Tian, Y. F., Lin, Y. S., Lu, C. L., Chia, C. C., Huang, K. F., Shih, T. Y., ... Wu, M. P. (2007). Major complications of operative gynecologic laparoscopy in Southern Taiwan: A follow-up study. Journal of Minimally Invasive Gynecology, 14(3), 284-292. https://doi.org/10.1016/j.jmig.2006.10.011

Major complications of operative gynecologic laparoscopy in Southern Taiwan : A follow-up study. / Tian, Yu Feng; Lin, Yue Shan; Lu, Chin Li; Chia, Chun Chieh; Huang, Kuo Feng; Shih, Tune Yie; Shen, Kun Hung; Chung, Ming Ting; Tsai, Yung Chieh; Chao, Chien Hsun; Wu, Ming Ping.

In: Journal of Minimally Invasive Gynecology, Vol. 14, No. 3, 05.2007, p. 284-292.

Research output: Contribution to journalArticle

Tian, YF, Lin, YS, Lu, CL, Chia, CC, Huang, KF, Shih, TY, Shen, KH, Chung, MT, Tsai, YC, Chao, CH & Wu, MP 2007, 'Major complications of operative gynecologic laparoscopy in Southern Taiwan: A follow-up study', Journal of Minimally Invasive Gynecology, vol. 14, no. 3, pp. 284-292. https://doi.org/10.1016/j.jmig.2006.10.011
Tian, Yu Feng ; Lin, Yue Shan ; Lu, Chin Li ; Chia, Chun Chieh ; Huang, Kuo Feng ; Shih, Tune Yie ; Shen, Kun Hung ; Chung, Ming Ting ; Tsai, Yung Chieh ; Chao, Chien Hsun ; Wu, Ming Ping. / Major complications of operative gynecologic laparoscopy in Southern Taiwan : A follow-up study. In: Journal of Minimally Invasive Gynecology. 2007 ; Vol. 14, No. 3. pp. 284-292.
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abstract = "Study objectives: This follow-up study examined the major complications among 4307 operative gynecologic laparoscopies. The overall complication rate and each individual category were compared with those of our previous study period. The clinical outcome and salvage procedures were correlated with the time of recognition and the severity of initial procedures in the individual injury type. Design: Retrospective, comparative study based on medical record reviewing (Canadian Task Force classification II-3). Setting: Tertiary teaching hospital, Chi Mei Foundation Hospital in southern Taiwan. Patients: Records of women (n = 4307) aged 40.5 ± 11.7 years (mean ± SD [95{\%} CI 40.1-40.5]) who underwent operative gynecologic laparoscopies from January 2000 through February 2006 were reviewed in this study. The complications were compared with those of our previous study based on 1507 laparoscopies performed between December 1992 and November 1999 for follow-up comparison. Interventions: Gynecologic laparoscopic surgeries. Measurements and main results: Thirty-four complications occurred in 31 patients requiring repair procedures, 3 of whom had multiple complications, with an overall complication rate of 0.72{\%} (31/4307). There were 13 bladder injuries (0.30{\%}), 7 bowel injuries (0.16{\%}), 3 cases of internal bleeding (0.07{\%}), 4 vaginal stump hematomas or abscesses (0.09{\%}), 3 ureteral injuries (0.07{\%}), 3 major vessel injuries (0.07{\%}), and 1 trocar site hematoma (0.02{\%}). In addition, there were 125 (2.88{\%}) postoperative blood transfusions without additional operative intervention. The major complication rate decreased compared with that of the previous study (0.72{\%} [95{\%} CI 0.51{\%}-1.02{\%}] vs 1.59{\%} [95{\%} CI 1.07{\%}-2.36{\%}]; p = .005). The overall complication rates were not significantly different between laparoscopic hysterectomy (LH) group and non-LH group. However, bladder injury happened more frequently in the LH group, whereas bowel injury was more common in the non-LH group. In addition, the severity of the original injury, timing of recognition, and accompanying salvage procedures correlated with the clinical outcomes. Conclusion: The significantly decreased major complication rate, as compared with that of our previous study period, confirms the importance of experience accumulation and use of preventive maneuvers in reducing the complication rate. There were no significant differences among the individual injury category during these 2 study periods. The manifestations of bowel injury were highly variable and individualized. The accumulation of surgical experience with the aid of preventive maneuvers is helpful to reduce the complication rate significantly.",
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AU - Huang, Kuo Feng

AU - Shih, Tune Yie

AU - Shen, Kun Hung

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KW - Bowel

KW - Complications

KW - Laparoscopy

KW - Major vessel injury

KW - Ureteral

KW - Vaginal stump hematoma

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