Erbil Yesim, Barbaros Umut, Sari Serkan, Agcaoglu Orhan, Salmaslioglu Artur, Ozarmagan Selcuk
Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
Surg Innov. 2010 Jun;17(2):114-9. doi: 10.1177/1553350610365703.
Obesity and visceral fat are thought to be the most important factors influencing the technical difficulty during open and laparoscopic surgery. The authors aimed to investigate the effect of retroperitoneal fat mass on surgical outcomes in patients undergoing laparoscopic adrenalectomy.
This prospective study included 51 consecutive patients who underwent lateral transabdominal laparoscopic adrenalectomy. Body mass index (BMI) and retroperitoneal fat area (RFA)/adrenal mass area (AMA) ratio were calculated.
There was a positive correlation between BMI and operating time and postoperative complications and hospital stay. According to 2-way analysis of variance, only RFA/AMA ratio (P = .0001) was found to significantly correlate with operating time, whereas BMI did not significantly correlate with operating time (P = .51). In patients with high BMI, high RFA indicated longer operating time and higher complication rate, whereas low RFA was associated with significantly shorter operating time and decreased risk of complications.
Retroperitoneal fat mass is a more useful parameter than BMI for predicting the surgical outcomes of laparoscopic adrenalectomy.
肥胖和内脏脂肪被认为是影响开放手术和腹腔镜手术技术难度的最重要因素。作者旨在研究腹膜后脂肪量对接受腹腔镜肾上腺切除术患者手术结局的影响。
这项前瞻性研究纳入了51例连续接受经腹侧腹腔镜肾上腺切除术的患者。计算体重指数(BMI)和腹膜后脂肪面积(RFA)/肾上腺肿块面积(AMA)比值。
BMI与手术时间、术后并发症及住院时间呈正相关。根据双向方差分析,仅RFA/AMA比值(P = .0001)与手术时间显著相关,而BMI与手术时间无显著相关性(P = .51)。在BMI较高的患者中,RFA较高表明手术时间较长且并发症发生率较高,而RFA较低则与手术时间显著缩短及并发症风险降低相关。
对于预测腹腔镜肾上腺切除术的手术结局,腹膜后脂肪量是比BMI更有用的参数。