Department of Surgery, Daejin Medical Center Bundang Jesaeng General Hospital, Sungnam-si, Republic of Korea.
Department of Radiology, Daejin Medical Center Bundang Jesaeng General Hospital, Sungnam-si, Republic of Korea.
Int J Surg. 2016 Dec;36(Pt A):225-232. doi: 10.1016/j.ijsu.2016.10.035. Epub 2016 Oct 26.
To our knowledge, this study is the first to identify the predictive factors and outcomes of prolonged operative time associated with laparoscopic appendectomy. We aimed to identify preoperative factors that influence operation time and to determine how operative time affects laparoscopic appendectomy outcomes.
The medical records of 3049 patients who had undergone laparoscopic appendectomy between January 2008 and December 2014 were retrospectively reviewed. Prolonged operative time was defined in the top 10% according to distribution (>90 min). A multivariate regression model was generated to assess potential predictive factors and outcomes of prolonged operative time.
In laparoscopic appendectomy for non-perforated appendicitis, independent factors that predict a prolonged operative time as identified through multivariate analysis were elevated C-reactive protein levels, symptom duration of more than 3 days, and computed tomography findings indicating an appendiceal diameter of more than 10 mm. In laparoscopic appendectomy for perforated appendicitis, overweight, elevated C-reactive protein, symptom duration of more than 3 days, and computed tomography findings of abscess were independent predictive factors for prolonged operative time. Prolonged surgery increases the risk of complications, prolonged hospital stay, and readmission.
Overweight, elevated C-reactive protein, symptom duration of more than 3 days, appendiceal diameter of more than 10 mm, and abscess were independent predictive factors of prolonged operative time. Furthermore, prolonged operative time was associated with adverse postoperative outcomes after laparoscopic appendectomy.
据我们所知，这项研究首次确定了与腹腔镜阑尾切除术相关的手术时间延长的预测因素和结果。我们旨在确定影响手术时间的术前因素，并确定手术时间如何影响腹腔镜阑尾切除术的结果。
回顾性分析了 2008 年 1 月至 2014 年 12 月期间接受腹腔镜阑尾切除术的 3049 例患者的病历。根据分布情况（>90 分钟），将手术时间延长定义为前 10%。生成多变量回归模型以评估手术时间延长的潜在预测因素和结果。
在非穿孔性阑尾炎的腹腔镜阑尾切除术中，通过多变量分析确定的独立预测手术时间延长的因素为 C 反应蛋白水平升高、症状持续时间超过 3 天以及 CT 检查提示阑尾直径超过 10mm。在穿孔性阑尾炎的腹腔镜阑尾切除术中，超重、C 反应蛋白升高、症状持续时间超过 3 天以及 CT 检查发现脓肿是手术时间延长的独立预测因素。手术时间延长会增加并发症、住院时间延长和再入院的风险。
超重、C 反应蛋白升高、症状持续时间超过 3 天、阑尾直径超过 10mm 和脓肿是手术时间延长的独立预测因素。此外，腹腔镜阑尾切除术后手术时间延长与不良术后结局相关。
