Patients criteria determining difficulty of the laparoscopic lateral transperitoneal adrenalectomy. A retrospective cohort study.
Int J Surg
; 43: 33-37, 2017 Jul.
Article
en En
| MEDLINE
| ID: mdl-28528215
ABSTRACT
BACKGROUND:
Identification of patients in whom adrenalectomy may be more difficult, can help in decision making in borderline and doubtful cases. The aim of the study was to determine patients criteria influencing difficulty of laparoscopic lateral transperitoneal adrenalectomy (LTA). MATERIAL ANDMETHODS:
The study enrolled 275 patients who underwent LTA. We analyzed the impact of gender, age, history of previous abdominal surgery, body mass index, risk of anesthesia measured as ASA scale, size, localization (left/right), and histological type of the tumor on parameters reflecting the level of difficulty of the procedure operative time, intraoperative blood loss, conversion rate and intraoperative complications rate.RESULTS:
Multivariate logistic regression showed that following factors were associated with longer operative time gender, tumor size and malignant lesions. In another model it was shown that age, size of the tumor and malignancy were associated with more excessive blood loss. Moreover, it was shown, that tumor size predictive factor for conversion. Univariate analysis showed a relation with malignancy, but multivariate analysis revealed no significance.CONCLUSIONS:
Patient age, gender, size and histological type of the tumor are criteria influencing parameters reflecting the level of difficulty. This criteria could be considered as predictors of the difficulty of LTA. Surgery in case of patients with combination of this risk factors should be handled by surgeon with sufficient experience to minimalize the risk of adverse events.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Laparoscopía
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Neoplasias de las Glándulas Suprarrenales
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Adrenalectomía
/
Selección de Paciente
Tipo de estudio:
Etiology_studies
/
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Año:
2017
Tipo del documento:
Article