Risk factors of perioperative complications and prolonged length of hospital stay in patients after laparoscopic adrenalectomy
LIU Jianyong1,2, LAI Shicong1,2, SONG Xinda1,2, WANG Xuan1, LIU Shengjie1, HOU Huimin1, LIU Ming1,2, WANG Jianye1,2
1Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China; 2Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences
Abstract：Objective： To explore the risk factors of perioperative complications and prolonged length of hospital stay after laparoscopic adrenalectomy Methods： A retrospective analysis was conducted on patients who underwent laparoscopic adrenalectomy from September 2011 to February 2019 in Beijing Hospital. Clinical pathological data including patient's age, gender, body mass index （BMI）, American Society of Anesthesiologists （ASA） score, comorbidities, previous abdominal surgery, tumor size and tumor side, pathological changes, postoperative hospital stay and postoperative complications were collected in detail. The risk degree of complications were scored using the Dindo-Clavien classification system. Univariate and multivariate logistic regression was used to explore the independent risk factors associated with postoperative complications and prolonged hospital stay. Results： A total of 206 patients, including 88 males and 118 females were included. ASA score was ≥ 3 grade in 22 patients. With the exception of 5 patients who were converted to open surgery, the rest patients successfully underwent laparoscopic surgery. The median tumor diameter was 3 （2.0-3.5） cm. There were 29 patients with Dindo-clavien grade 2 or above, and the overall complication was reported in 14.1% of cases. Fifty-three patients were hospitalized for more than one week. Multivariate logistic regression analysis showed that ASA score ≥3 and tumor diameter ≥ 6 cm were independent risk factors for postoperative complications （OR = 3.884, 95%CI： 1.218-12.386, P = 0.022; OR = 4.382, 95%CI： 1.106-17.371, P=0.035） and prolonged hospital stay （OR = 3.565, 95%CI： 1.239-10.258, P = 0.018; OR = 5.008, 95%CI： 1.378-18.194; P = 0.014）. Conclusion： Laparoscopic adrenalectomy remains safe. ASA score ≥ 3 and tumor diameter ≥ 6 cm were independent risk factors for postoperative complications and prolonged hospital stay.
刘建勇, 赖世聪, 宋新达, 王萱, 刘圣杰, 侯惠民, 刘明, 王建业. 腹腔镜肾上腺肿瘤切除术后并发症发生及住院时间延长的相关危险因素[J]. 微创泌尿外科杂志, 2020, 9(5): 294-299.
LIU Jianyong, LAI Shicong, SONG Xinda, WANG Xuan, LIU Shengjie, HOU Huimin, LIU Ming, WANG Jianye. Risk factors of perioperative complications and prolonged length of hospital stay in patients after laparoscopic adrenalectomy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(5): 294-299.
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