Effect of preoperative computed tomography parameters and obesity on surgical outcomes of laparoendoscopic single-site adrenalectomy
Background The aims of the present study were to (1) analyse preoperative computed tomography (CT) parameters, (2) investigate whether obesity and CT parameters affect surgical outcomes in patients undergoing LESS lateral retroperitoneal adrenalectomy, and (3) further establish the optimal cutoff point of CT parameters for tolerable operating time. Methods Between January 2010 and August 2016, patients who underwent LESS adrenalectomy through the retroperitoneal approach in our hospitals were included. Patients’ demographic data, preoperatively measured CT parameters (the depth and horizontal width to the adrenal gland in the axial view of abdominal CT, the vertical height in the coronal view of CT, and the angle of the depth and horizontal width), and intraoperative (operative time and blood loss) and postoperative (hospital stay and complications) parameters were retrospectively reviewed. Linear regression was performed to determine factors that potentially affect surgical outcomes. Results In 116 patients, depth was the only CT parameter associated with surgical outcomes. Large depth (P = 0.005; 95% CI 1.739–9.256) and high BMI (P = 0.012; 95% CI 0.357–2.851) were factors significantly associated with longer operative time. The area under the ROC curve for the depth was 0.69 (P = 0.002), and the cutoff point 10.48 cm may be the tolerable operating time. Conclusions Our results suggest a depth limit of 10.48 cm for the optimal prediction of operating time less than 90 min; although obese patients and deeper adrenal glands had longer operative time, LESS adrenalectomy could be performed in the obese patients without increased blood loss, prolonged hospital stay, or increased pain..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
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| Enthalten in: |
Surgical endoscopy - 34(2019), 11 vom: 02. Dez., Seite 4781-4787 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chen, Yu-Chen [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Adrenalectomy |
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| Anmerkungen: |
© Springer Science+Business Media, LLC, part of Springer Nature 2019 |
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| doi: |
10.1007/s00464-019-07254-3 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC212019517X |
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| 520 | |a Background The aims of the present study were to (1) analyse preoperative computed tomography (CT) parameters, (2) investigate whether obesity and CT parameters affect surgical outcomes in patients undergoing LESS lateral retroperitoneal adrenalectomy, and (3) further establish the optimal cutoff point of CT parameters for tolerable operating time. Methods Between January 2010 and August 2016, patients who underwent LESS adrenalectomy through the retroperitoneal approach in our hospitals were included. Patients’ demographic data, preoperatively measured CT parameters (the depth and horizontal width to the adrenal gland in the axial view of abdominal CT, the vertical height in the coronal view of CT, and the angle of the depth and horizontal width), and intraoperative (operative time and blood loss) and postoperative (hospital stay and complications) parameters were retrospectively reviewed. Linear regression was performed to determine factors that potentially affect surgical outcomes. Results In 116 patients, depth was the only CT parameter associated with surgical outcomes. Large depth (P = 0.005; 95% CI 1.739–9.256) and high BMI (P = 0.012; 95% CI 0.357–2.851) were factors significantly associated with longer operative time. The area under the ROC curve for the depth was 0.69 (P = 0.002), and the cutoff point 10.48 cm may be the tolerable operating time. Conclusions Our results suggest a depth limit of 10.48 cm for the optimal prediction of operating time less than 90 min; although obese patients and deeper adrenal glands had longer operative time, LESS adrenalectomy could be performed in the obese patients without increased blood loss, prolonged hospital stay, or increased pain. | ||
| 650 | 4 | |a Adrenalectomy | |
| 650 | 4 | |a Laparoscopy | |
| 650 | 4 | |a Obesity | |
| 650 | 4 | |a Treatment outcome | |
| 650 | 4 | |a Computed tomography | |
| 700 | 1 | |a Lee, Hsiang-Ying |4 aut | |
| 700 | 1 | |a Shih, Ming-Chen Paul |4 aut | |
| 700 | 1 | |a Juan, Yung-Shun |4 aut | |
| 700 | 1 | |a Chen, Hao-Wei |4 aut | |
| 700 | 1 | |a Wu, Wen-Jeng |4 aut | |
| 700 | 1 | |a Wang, Yu-Tsang |4 aut | |
| 700 | 1 | |a Li, Ching-Chia |4 aut | |
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