TAILIEUCHUNG - Surgical complications - part 7

Tất cả các biến chứng uretero-renoscopic là tốt nhất ngăn ngừa bằng cách sử dụng phạm vi đường kính nhỏ nhất cần thiết, kháng sinh dự phòng, dây một hướng dẫn an toàn tại tất cả các lần để đánh dấu con đường ureteric, tránh vượt quá sự giãn nở ureteric và sau phẫu thuật đặt stent nếu có thể. | 588 T J. Greenwell A. R. Mundy All uretero-renoscopic complications are best prevented by using the smallest diameter scope necessary prophylactic antibiotics a safety guide wire at all times to mark the ureteric path avoiding excess ureteric dilation and postoperative stenting if possible. The energy sources used to accomplish stone or tumour eradication during uretero-renoscopy contribute to its morbidity. USS results in heat generation and can cause thermal damage. Extrahydraulic lithotripsy EHL causes mechanical trauma and results in perforation in 0 19 of the cases which is generally treated by stenting . Laser causes perforation and or stricture in 0 6 . The lithoclast is the safest but least efficient in terms of successful stone eradication. When ureteric stricture or avulsion injury occurs it should be managed as detailed COMPLICATIONS OF RADICAL CYSTECTOMY AND RADICAL CYSTOPROSTATECTOMY Table 5 For muscle invasive non-metastatic bladder cancer all types especially TCC the treatment of choice is radical cystectomy for female patients and radical cystoprostatectomy for Table 5. Complications ofRadical Cystectomyand Radical Cystoprostatectomy Complications Incidence Death 1-3 Morbidity 25-41 Transfusion 10 units Rectal Injury Wound Infection 5-10 Sepsis Pelvic Abscess Pneumonia Acute PN Cholecystitis Erectile 25-100 depending Dysfunction ED on nerve sparing or not Complications of Urological Surgery 589 Blood loss is expected at cystectomy and a mean of units of blood is transfused per In a small percentage the loss is more extensive and the management involves invasive perioperative monitoring and prompt and appropriate blood and fluid replacement. An elective admission to the intensive care unit ICU for postoperative management is routine. Rectal injury occurs in up to 10 64 69-71 and is more likely to occur in patients with a history of radiotherapy70 71 especially high dose .

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