비뇨기과 복강경 수술 후 발생하는 내과적 합병증 발생에 영향을 미치는 인자에 대한 연구
The Factors Affecting Non-Urologic Postoperative Complications after Laparoscopic Surgery in the Urologic Area
이상협, 유구한, 민경은, 이형래, 장성구, 전승현,
소속 상세정보
이상협 ( Lee Sang-Hyub )
경희대학교 의과대학 비뇨기과학교실
유구한 ( Yoo Koo-Han )
경희대학교 의과대학 비뇨기과학교실
민경은 ( Min Kyeong-Eun )
경희대학교 의과대학 비뇨기과학교실
이형래 ( Lee Hyung-Lae )
경희대학교 의과대학 비뇨기과학교실
장성구 ( Chang Sung-Goo )
경희대학교 의과대학 비뇨기과학교실
전승현 ( Jeon Seung-Hyun )
경희대학교 의과대학 비뇨기과학교실
KMID : 0358320090500080780
Abstract
Purpose: Factors related to nonurologic postoperative complications of laparoscopic surgery in the urologic area were examined. The most significant factors were isolated and analyzed to establish ways to reduce the complication rate.
Materials and Methods : The medical records of 154 patients who had undergone laparoscopic surgery between March 2004 and March 2008 were reviewed. Age, anesthetic time, American Society of Anesthesiologists physical status classification, operative difficulty, blood loss (ml), body mass index (BMI), and complications were assessed. Complications were divided into 5 groups based on the modified Clavien classification. Grade 0 to 1 was defined as a no complication group and grades 2 to 5 as a complication group. The Armitage trend test was performed to study the relations between the factors and the complications. Univariate and multivariate analyses were performed to determine the risk ratio of each of the factors and the most significant factors.
Results: Complications tended to increase as the anesthetic risk and anesthetic time increased (p=0.011, 0.013, respectively). Operative difficulty and blood loss were related to complications (p=0.018, p＜0.001, respectively). The univariate analysis revealed that blood loss of more than 400 ml compared with less than 200 ml had a risk ratio of 18.2. Moderate and hard operative difficulties had a significant risk ratio of around 4, and high anesthetic risk had a high risk rate of around 5. The multivariate analysis showed that blood loss and high anesthetic risk were independent risk factors of complications.
Conclusions: Blood loss and high anesthetic risk proved to be independent factors that are associated with complications. Surgeons must keep in mind the patient’s anesthetic risk and try to minimize blood loss during the operation to reduce complications after a laparoscopic surgery. (Korean J Urol 2009;50:780-785)
키워드
Laparoscopy;Surgery;Urology;Complications
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