[Relaparoscopy in the treatment of complications after laparoscopic urological procedures].

OBJECTIVES: To propose relaparoscopy as a feasible diagnostic tool and an efficient treatment in early abdominal complications after urologic laparoscopic procedures in selected patients that require surgical intervention. METHODS: Between January 2008 and April 2011, a total of 246 laparoscopic urologic procedures were performed at our institution. There were 81 radical nephrectomies (33%), 46 radical prostatectomies (19%), 31 pyeloplasties (13%), 28 partial nephrectomies (11%), 6 radical cystectomies (2%) and 54 miscellaneous (22%). Mean age was 53 years (range 15 to 84 years). Male/female ratio was 2.4:1. Patient's ASA score was 1, 2, 3 and 4 in 48%, 44%, 7.5% and 0.5% respectively. Mean postoperative stay was 2.7 days (range 1 to 8 days). RESULTS: A total of 4 patients (1.6%) developed severe abdominal complications that required surgical intervention. All cases were reoperated laparoscopically. Mean operative time was 57 minutes (range 40 to 80 minutes), and mean hospital stay was 3.7 days (range 3 to 5 days). All patients evolved uneventfully and did not require further treatment. CONCLUSION: Surgical complications secondary to laparoscopic urologic procedures can be safely reoperated by means of laparoscopy especially in hemodinamically stable patients.

Relaparoscopia en el tratamiento de complicaciones de cirugia laparoscopica urologica / Relaparoscopy in the treatment of complications after laparoscopic urological procedures

OBJETIVO: Proponer la cirugía laparoscópica como una herramienta de diagnóstica y terapéutica eficaz de las complicaciones abdominales tempranas posteriores a las cirugías laparoscópicas urológicas en pacientes seleccionados que requieran una reoperación. MÉTODOS: Entre enero de 2008 y abril de 2011 se efectuaron un total de 246 laparoscopías urológicas en nuestra institución. Se realizaron 81 nefrectomías radicales (33%), 46 prostatectomías radicales (19%), 31 pieloplastías (13%), 28 nefrectomías parciales (11%), 6 cistectomías radicales (2%) y 54 misceláneas (22%). La edad media fue 53 años (rango 15 a 84 años). La relación hombre / mujer fue de 2.4:1. El 48% presentaba ASA 1, el 44% ASA 2, el 7.5% ASA 3 y el 0.5% ASA 4. La media en días de estadía postoperatorios fue 2.7 días (rango entre 1 y 8 días). RESULTADOS: Un total de 4 pacientes (1.6%) presentaron complicaciones abdominales que requirieron una reintervención quirúrgica temprana, realizandose todas por vía laparoscópica. El tiempo promedio fue de 57 minutos (rango 40 a 80 minutos) y la estadía hospitalaria promedio fue de 3.7 días (rango 3 a 5 días). Todos los pacientes tratados evolucionaron favorablemente y no requirieron posteriores intervenciones. CONCLUSIÓN: Las complicaciones de cirugías laparoscópicas urológicas pueden ser tratadas en forma segura y eficaz por la misma vía en pacientes seleccionados, fundamentalmente en casos de hemorragia en pacientes estabilizados(AU)

OBJECTIVES: To propose relaparoscopy as a feasible diagnostic tool and an efficient treatment in early abdominal complications after urologic laparoscopic procedures in selected patients that require surgical intervention. METHODS: Between January 2008 and April 2011, a total of 246 laparoscopic urologic procedures were performed at our institution. There were 81 radical nephrectomies (33%), 46 radical prostatectomies (19%), 31 pyeloplasties (13%), 28 partial nephrectomies (11%), 6 radical cystectomies (2%) and 54 miscellaneous (22%).Mean age was 53 years (range 15 to 84 years). Male / female ratio was 2.4:1. Patient’s ASA score was 1, 2, 3 and 4 in 48%, 44%, 7.5% and 0.5% respectively. Mean postoperative stay was 2.7 days (range 1 to 8 days). RESULTS: A total of 4 patients (1.6%) developed severe abdominal complications that required surgical intervention. All cases were reoperated laparoscopically. Mean operative time was 57 minutes (range 40 to 80 minutes), and mean hospital stay was 3.7 days (range 3 to 5 days). All patients evolved uneventfully and did not require further treatment. CONCLUSION: Surgical complications secondary to laparoscopic urologic procedures can be safely reoperated by means of laparoscopy especially in hemodinamically stable patients(AU)