腹腔镜肾上腺切除术并发症发生率与肥胖的相关性分析

Correlation of increasing complication rate in obese patients undergoing laparoscopic adrenalectomy

目的探讨分析腹腔镜肾上腺切除术并发症的发生率与肥胖的相关性。方法回顾性分析2009年1月至2017年1月我院接受腹腔镜肾上腺切除手术的80例患者的临床资料,对患者一般资料进行收集整理。对腹腔镜肾上腺切除手术并发症的发生率与肥胖的相关性进行统计学分析。结果 80例患者中,43例患者体质量指数(BMI)≥30 kg/m2,37例患者BMI<30 kg/m2,两组在年龄、性别、手术侧别、病变肾上腺大小、合并症、手术时间、出血量等方面差异无统计学意义。BMI≥30 kg/m2组中9例患者出现并发症,BMI<30 kg/m2组中2例患者出现并发症。两组手术并发症差异有统计学意义(P=0.04)。在包括肥胖(BMI≥30 kg/m2)、年龄、性别、手术侧别、手术时间、出血量、病变肾上腺大小、合并症的多因素Logistic回归分析中,肥胖和年龄为独立的危险因素。结论肥胖患者腹腔镜肾上腺切除手术并发症发生率较非肥胖患者高,肥胖患者进行腹腔镜肾上腺切除手术应特别注意围手术期准备,从而降低手术并发症的发生。

Objective To investigate the correlation of increasing complication rate in obese patients undergoing laparoscopic adrenalectomy.Method A retrospective chart review was performed on 80 patients undergoing laparoscopic adrenalectomy between January 2009 and January 2017.Clinical data was reviewed retrospectively.The correlation of increasing complication rate in obese patients undergoing laparoscopic adrenalectomy was analyzed.Result A total of 80 patients underwent laparoscopic adrenalectomy.Forty three patients were considered obese based on the body mass index criteria.Thirtyseven patients were considered healthy weight.Operative time,sex,mean age,mass size,operation side,estimated blood loss,and comorbidities did not differ significantly between the 2 cohort groups.Complications occured in a patients of the obese population and occured in 2 patients of the healthy weight population.The rate of complication in the obese population was higher than that in the healthy weight population(P=0.04).The multivariate regression analysis revealed that the main determinants of increasing complication rate after laparoscopic adrenalectomy were age and the body mass index≥30 kg/m^2.Conclusion A significant increase occurred in intraoperative and postoperative complications for obese individuals undergoing laparoscopic adrenalectomy compared with healthy weight individuals.However,obese individuals should be paid attention to perioperation period before laparoscopic adrenalectomy.It is effective,with decreasing complication rate in obese patients undergoing laparoscopic adrenalectomy.