The role of computerized tomography in the evaluation of complications after laparoscopic urological surgery

Jeffrey A Cadeddu, Fintan Regan, Louis R. Kavoussi, Robert G. Moore

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: Radiographic evaluation may be necessary to assess the possible complications of laparoscopic procedures. We undertook a retrospective review to determine the indications for and findings of computerized tomography (CT) in symptomatic patients after urologic laparoscopic surgery. Materials and Methods: Of 400 laparoscopic urological procedures performed between July 1993 and September 1996, 20 patients (5%) had postoperative symptomatology that could not be explained by physical exam or routine clinical studies. An abdominal CT scan was obtained (1 to 120 days after the procedure) to help determine a diagnosis. CT findings were correlated with the indication for the study and clinical followup. Results: The indications for CT were unexplained pain, fever, leukocytosis or falling hematocrit. Thirteen patients had significant findings related to their surgery that were identified by CT. In 2 cases, we identified pathology unrelated to the surgery. Therefore, CT identified a symptom-related diagnosis in 75% of patients (15 of 20). Each scan for decreasing hematocrit demonstrated a hematoma. In all patients with unexplained fever or leukocytosis, CT revealed the cause. CT evaluation of atypical postoperative pain demonstrated a pathological cause in 58% (7 of 12). Percutaneous or laparoscopic surgical intervention was required in 4 of 20 patients. In 8 patients scanned by postoperative day 6, intraperitoneal or retroperitoneal gas was identified in 3 who had an abdominal incision made for intact specimen removal and in 1 with a perforated ulcer. Conclusions: CT after urologic laparoscopy is indicated in patients with significant clinical findings in whom routine examination and tests are not diagnostic. CT can reliably identify postoperative bleeding, urinary leak or obstruction and can also detect nonurinary pathology.

Original languageEnglish (US)
Pages (from-to)1349-1352
Number of pages4
JournalJournal of Urology
Volume158
Issue number4
DOIs
StatePublished - Oct 1997

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Laparoscopy
Tomography
Leukocytosis
Hematocrit
Fever
Accidental Falls
Pathology
Postoperative Pain
Routine Diagnostic Tests
Hematoma
Ulcer
Gases
Hemorrhage
Pain

Keywords

  • Laparoscopy
  • Tomography, x-ray computed

ASJC Scopus subject areas

  • Urology

Cite this

The role of computerized tomography in the evaluation of complications after laparoscopic urological surgery. / Cadeddu, Jeffrey A; Regan, Fintan; Kavoussi, Louis R.; Moore, Robert G.

In: Journal of Urology, Vol. 158, No. 4, 10.1997, p. 1349-1352.

Research output: Contribution to journalArticle

Cadeddu, Jeffrey A ; Regan, Fintan ; Kavoussi, Louis R. ; Moore, Robert G. / The role of computerized tomography in the evaluation of complications after laparoscopic urological surgery. In: Journal of Urology. 1997 ; Vol. 158, No. 4. pp. 1349-1352.
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