C Chapron1, L Cravello, N Chopin, G Kreiker, B Blanc, J B Dubuisson. 1. Assistance Publique des Hôpitaux de Paris, Service de Gynécologie Obstétrique II, Unité de Chirurgie, Clinique Universitaire Baudelocque, CHU Cochin Port-Royal, Paris, France. charles.chapron@cch.ap-hop-paris.fr
Abstract
OBJECTIVE: To compare the risk of major complications during the set-up procedures for laparoscopy according to whether the classic technique (creation of the pneumoperitoneum followed by introduction of the optics trocar) or open laparoscopy is used. METHODS: Comparison was made of two retrospective series each carried out in a department promoting one of the two techniques. The setting was a university-affiliated hospital. Two groups of patients were compared: group A, classic laparoscopy, n = 8324; group B, open laparoscopy, n = 1562. We investigated the set-up procedures of operative laparoscopy according to the rules of classic or open laparoscopy. RESULTS: The risk of failure requiring conversion to laparotomy is significantly higher in the group of patients who underwent open laparoscopy [three cases (0.19%) vs. 0 case (0.0%); p = 0.004]. The risk of major complications is comparable in the two groups [group A, four cases (0.05%) vs. group B, three cases (0.19%); p = 0.08]. In the classic laparoscopy group there were four major complications: one injury to the aorta and three bowel injuries. In the open laparoscopy group there were three major complications: two bowel injuries and one postoperative occlusion. CONCLUSIONS: Open laparoscopy does not reduce the risk of major complications during the set-up procedures for laparoscopy. Randomized prospective trials are indispensable for comparing the risks involved with the classic technique and those of open laparoscopy.
OBJECTIVE: To compare the risk of major complications during the set-up procedures for laparoscopy according to whether the classic technique (creation of the pneumoperitoneum followed by introduction of the optics trocar) or open laparoscopy is used. METHODS: Comparison was made of two retrospective series each carried out in a department promoting one of the two techniques. The setting was a university-affiliated hospital. Two groups of patients were compared: group A, classic laparoscopy, n = 8324; group B, open laparoscopy, n = 1562. We investigated the set-up procedures of operative laparoscopy according to the rules of classic or open laparoscopy. RESULTS: The risk of failure requiring conversion to laparotomy is significantly higher in the group of patients who underwent open laparoscopy [three cases (0.19%) vs. 0 case (0.0%); p = 0.004]. The risk of major complications is comparable in the two groups [group A, four cases (0.05%) vs. group B, three cases (0.19%); p = 0.08]. In the classic laparoscopy group there were four major complications: one injury to the aorta and three bowel injuries. In the open laparoscopy group there were three major complications: two bowel injuries and one postoperative occlusion. CONCLUSIONS: Open laparoscopy does not reduce the risk of major complications during the set-up procedures for laparoscopy. Randomized prospective trials are indispensable for comparing the risks involved with the classic technique and those of open laparoscopy.
Authors: S Burghaus; T Fehm; P A Fasching; S Blum; S K Renner; F Baier; T Brodkorb; C Fahlbusch; S Findeklee; L Häberle; K Heusinger; T Hildebrandt; J Lermann; O Strahl; G Tchartchian; B Bojahr; A Porn; M Fleisch; S Reicke; T Füger; C-P Hartung; J Hackl; M W Beckmann; S P Renner Journal: Geburtshilfe Frauenheilkd Date: 2016-08 Impact factor: 2.915
Authors: Vicki Nisenblat; Patrick M M Bossuyt; Rabia Shaikh; Cindy Farquhar; Vanessa Jordan; Carola S Scheffers; Ben Willem J Mol; Neil Johnson; M Louise Hull Journal: Cochrane Database Syst Rev Date: 2016-05-01
Authors: Devashana Gupta; M Louise Hull; Ian Fraser; Laura Miller; Patrick M M Bossuyt; Neil Johnson; Vicki Nisenblat Journal: Cochrane Database Syst Rev Date: 2016-04-20
Authors: Emily Liu; Vicki Nisenblat; Cindy Farquhar; Ian Fraser; Patrick M M Bossuyt; Neil Johnson; M Louise Hull Journal: Cochrane Database Syst Rev Date: 2015-12-23