Effect of preoperative computed tomography parameters and obesity on surgical outcomes of laparoendoscopic single-site a
- PDF / 788,017 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 8 Downloads / 175 Views
and Other Interventional Techniques
Effect of preoperative computed tomography parameters and obesity on surgical outcomes of laparoendoscopic single‑site adrenalectomy Yu‑Chen Chen1,2 · Hsiang‑Ying Lee1,2,3 · Ming‑Chen Paul Shih4 · Yung‑Shun Juan1,2,3 · Hao‑Wei Chen1,2 · Wen‑Jeng Wu1,2 · Yu‑Tsang Wang5 · Ching‑Chia Li1,2 Received: 10 May 2019 / Accepted: 11 November 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract 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. Keywords Adrenalectomy · Laparoscopy · Obesity · Treatment outcome · Computed tomography
* Ching‑Chia Li [email protected] 1
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
2
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
3
Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
4
Department of Radiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
5
Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
In the last 20 years, laparoscopic adrenalectomy has become a standard operating method, replacing conventional open surgery. Recently, minimally invasive adren
Data Loading...
