Intraoperative and Early Postoperative Complications of Radical Retropubic Prostatectomy
Intraoperative and Early Postoperative Complications of Radical Retropubic Prostatectomy
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根治性耻骨后前列腺切除术的术中和术后早期并发症
DOI：
10.1159/000107953
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发表时间：
2007
影响因子：
1.6
通讯作者：
D. Kroepfl
中科院分区：
文献类型：
--
作者：
V. Klevecka;Luise Burmester;M. Musch;U. Roggenbuck;D. Kroepfl
前言：目的了解根治性耻骨后前列腺切除术（RRP）围手术期并发症及发病率，并分析观察到并发症的危险因素。材料与方法：收集同一医院不同外科医生行RRP和盆腔淋巴结切除术（pLA）的1000例患者的资料。进行单因素和多因素分析，以检测手术内和术后并发症与特定变量之间的关系。结果：术中相关并发症28例，术后相关并发症187例，需再手术46例。75例发生各种轻微术后并发症。手术经验和手术时间对术中并发症的发生率有显著影响。延长的pLA与淋巴细胞瘤和再手术的发生率显著升高相关。淋巴囊肿患者的深静脉血栓形成（DVT）、肺栓塞（PE）及再手术发生率明显高于其他患者，且DVT患者的PE及再手术发生率明显高于其他患者。吻合口狭窄发生率与术后尿潴留有显著相关性。结论：RRP是一种安全的手术方法。在经验丰富的泌尿外科医生手中，它与严重术中并发症的发生率较低有关。相当大比例的术后并发症与pLA及其延伸有关。
Introduction: To determine the perioperative complications and morbidity of radical retropubic prostatectomy (RRP) and to analyze risk factors for observed complications. Materials and Methods: Data of 1,000 patients undergoing RRP and pelvic lymphadenectomy (pLA) performed by different surgeons of the same hospital were collected. Uni- and multivariate analysis was performed to detect associations between intra- and postoperative complications and specific variables. Results: Relevant intraoperative complications were observed in 28 cases and relevant postoperative complications in 187 cases requiring reoperations in 46 patients. Diverse minor postoperative complications occurred in 75 cases. The surgeon’s experience and the operating time significantly influenced the incidence of intraoperative complications. Extended pLA was associated with significantly higher rates of lymphoceles and reoperations. The patients with lymphocele showed significantly higher rates of deep venous thrombosis (DVT), pulmonary embolism (PE) and reoperation and patients with DVT a higher incidence of PE and a higher rate of reoperations. The incidence of anastomotic strictures correlated significantly with postoperative urine retention. Conclusions: RRP is a safe surgical procedure. In the hands of experienced urologic surgeons it is associated with lower incidences of severe intraoperative complications. A substantial proportion of postoperative complications are associated with pLA and its extension.