BMI对腹膜后腹腔镜肾上腺肿瘤切除手术时间的影响

Effect of body mass index on the operative time of retroperitoneal laparoscopic adrenal neoplasm resection

目的探讨体质指数(BMI)对腹膜后腹腔镜肾上腺肿瘤切除手术时间的影响。方法收集2019年1月至2020年12月无锡市锡山人民医院泌尿外科行腹膜后腹腔镜下肾上腺肿瘤切除术患者的临床资料。根据BMI不同分为正常组(BMI<25 kg/m^(2))和超重组(BMI≥25 kg/m^(2)),比较两组患者的年龄、性别、肿瘤最大直径、肿瘤左右位置、手术时间、术中出血量、术后住院天数。采用多重线性回归分析影响手术时间的临床因素。结果共47例患者纳入研究,正常组27例,超重组20例。两组患者的年龄、性别、肿瘤最大直径、左右位置、术中出血量、术后住院天数无统计学差异。超重组手术时间较正常组延长[(73.8±15.1)min vs(63.7±15.0)min,P=0.029]。多重线性回归分析结果显示BMI和年龄是影响手术时间的危险因素;根据标准回归系数,BMI对手术时间的影响(0.346)大于年龄对手术时间的影响(0.331)。进一步将手术时间与BMI进行Pearson相关分析,结果显示二者存在相关性(r=0.375,P=0.009)。结论在腹膜后腹腔镜肾上腺肿瘤切除术中,超重患者比BMI正常患者的手术时间长,且BMI增加是手术时间延长的临床危险因素。

Objective To investigate the effect of BMI on the operative time for patients undergoing retroperitoneal laparoscopic adrenal neoplasm resection.Methods A retrospective cohort study was conducted among 47 patients with adrenal neoplasm who had undergone retroperitoneal laparoscopic adrenal neoplasm resection from January 2019 to December 2020 in our department.All patients were divided into two groups according BMI class:normal group(BMI<25 kg/m^(2),n=27),and overweight group(BMI≥25 kg/m^(2),n=20).The data of age,gender,the maximum diameter of neoplasm,neoplasm location,operative time,intraoperative blood loss,and postoperative hospital stay were analyzed and compared.Results The two groups were comparable in terms of age,gender,maximum diameter of neoplasm,neoplasm location,intraoperative blood loss,and postoperative hospital stay.The operative time of the overweight group was significantly longer than that of the normal group[(73.8±15.1)min vs(63.7±15.0)min,P=0.029)].In the analysis of multiple linear regression,it was found that longer operative time was associated with greater BMI and older age.The influence of BMI was greater than that of age(0.346 vs 0.331).Further Pearson correlation analysis was conducted between operative time and BMI,and the results showed a statistical correlation between the two factors(r=0.375,P=0.009).Conclusions BMI was a major factor associated with longer operative time in retroperitoneal laparoscopic adrenal neoplasm resection.