Author/Editor		Boršoš, Imre; Podboj, Jernej
Title		Iatrogene poškodbe in zapleti pri endoskopski kirurgiji nosu in obnosnih votlin
Translated title		Iatrogenic injuries and complications in endoscopic surgery of the nose and paranasal sinuses
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 5, št. 11
Publication year		2000
Volume		str. 15-9
Language		slo
Abstract		Background. Endoscopic surgery is indispensable in the treatment of patiets with nasal sinus disesases. The paper presents iatrogenic injuries and complications secondary to endoscopic surgery of nasal sinuses. Medico-legally, iatrogenic injuries and complications are classified as very serious, serious and minor. Patients. In 3,099 patients treated at the Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, 4,611 endoscopic nasal and sinus procedures were done during the period 1986-1999, including: 2,027 meatotomies, 1,979 ethmoidectomies, 197 endoscopic operations for epistaxis and 408 diagnostic endoscopies. Results. Iatrogenic injuries occurred in 36 patients and the resultant complications in 27. Endoscopic ethmoidectomy was associated with the highest rate of injuries and complications, the most frequent one being lesion of the lamina papyracea. Concluisons. The total rate of iatrogenic complications has notably declined in recent years. Although some serious and potentially hazardous occurred in our patients, no major complications were documented. The results obtained are attributable to the experience of surgical staff and proper management of iatrogenic injuries and complications. Endoscopic sinus surgery is a very effective operative technique, yet it is safe only in the hands of a well-trained, experienced surgeon.
Summary		Izhodišča. Endoskopska kirurgija je nepogrešljiva pri obravnavanju bolnikov z boleznimi nosu in obnosnih votlin. V našem prispevku prikazujemo iatrogene okvare in zaplete pri endoskopiji in endoskopski kirurgiji obnosnih votlin. Iatrogene okvare in njihove zaplete razvrščamo z medikolegalnega stališča v posebno hude, hude in lahke. Bolniki. Na Kliniki za otorinolaringologijo in cervikalno kirurgijo v Ljubljani smo od leta 1986 do leta 1999 pri 3099 bolnikih naredili 4611 endoskopskih pregledov in posegov v nosu in obnosnih votlinah, od tega 2027 meatotomij, 1979 etmoidektomij, 197 endoskopskih obravnav epistakse in 408 diagnostičnih endoskopij. Rezultati. Pri 36 bolnikih je prišlo do iatrogene poškodbe in pri 27 bolnikih do posledičnih zapletov. Največ poškodb in zapletov je bilo pri endoskopski etmoidektomiji, med njimi najpogostejša poškodba lamine papiraceje. Zaključki. Število vseh zapletov je v zadnjem obdobju občutno manjše. Kljub nekaterih hudim, potencialno nevarnim iatrogenim poškodbam, nismo imeli hudih zapletov. Rezultate pripisujemo pridobljenim izkušnjam in pravilnim ukrepom pri iatrogenih poškodbah in zapletih. Endoskopska sinusna kirurgija je sicer zelo uspešna, vendar je dovolj varna le v rokah izkušenega kirurga.
Descriptors		NOSE PARANASAL SINUSES SURGERY, ENDOSCOPIC INTRAOPERATIVE COMPLICATIONS POSTOPERATIVE COMPLICATIONS CLINICAL COMPETENCE ETHMOID SINUS