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肥胖及腰围增加对腹腔镜肾切除术预后的影响

The Effect of Obesity and Increased Waist Circumference on the Outcome of Laparoscopic Nephrectomy.

作者信息

Hennessey D B, Bolton E M, Thomas A Z, Manecksha R P, Lynch T H

机构信息

Department of Urological Surgery, St. James's Hospital, James's Street, Dublin 8, Ireland.

出版信息

Adv Urol. 2017;2017:3941727. doi: 10.1155/2017/3941727. Epub 2017 Jan 22.

Abstract

. The prevalence of obesity is increasing worldwide. Obesity can be determined by body mass index (BMI); however waist circumference (WC) is a better measure of central obesity. This study evaluates the outcome of laparoscopic nephrectomy on patients with an abnormal WC. . A WC of >88 cm for women and >102 cm for men was defined as obese. Data collected included age, gender, American Society of Anaesthesiologists (ASA) score, renal function, anaesthetic duration, surgery duration, blood loss, complications, and duration of hospital stay. . 144 patients were assessed; 73 (50.7%) of the patients had abnormal WC for their gender. There was no difference between the groups for conversion to open surgery, number of ports used, blood loss, and complications. Abnormal WC was associated with a longer median anaesthetic duration, 233 min, IQR (215-265) versus 204 min, IQR (190-210), = 0.0022, and operative duration, 178 min, IQR (160-190) versus 137 min, IQR (128-162), < 0.0001. Patients with an abnormal WC also had a longer inpatient stay, = 0.0436. . Laparoscopic nephrectomy is safe in obese patients. However, obese patients should be informed that their obesity prolongs the anaesthetic duration and duration of the surgery and is associated with a prolonged recovery.

摘要

全球肥胖症的患病率正在上升。肥胖可通过体重指数(BMI)来确定;然而,腰围(WC)是衡量中心性肥胖的更好指标。本研究评估了腹腔镜肾切除术对腰围异常患者的治疗效果。女性腰围>88厘米、男性腰围>102厘米被定义为肥胖。收集的数据包括年龄、性别、美国麻醉医师协会(ASA)评分、肾功能、麻醉持续时间、手术持续时间、失血量、并发症以及住院时间。对144例患者进行了评估;其中73例(50.7%)患者的腰围与其性别不匹配。两组在转为开放手术、使用的端口数量、失血量和并发症方面没有差异。腰围异常与中位麻醉持续时间延长有关,分别为233分钟,四分位数间距(IQR)(215 - 265)与204分钟,IQR(190 - 210),P = 0.0022,以及手术持续时间延长有关,分别为178分钟,IQR(160 - 190)与137分钟,IQR(128 - 162),P < 0.0001。腰围异常的患者住院时间也更长,P = 0.0436。腹腔镜肾切除术对肥胖患者是安全的。然而,应告知肥胖患者,他们的肥胖会延长麻醉持续时间和手术时间,并与恢复时间延长有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b57/5292162/bb4b2d94c02b/AU2017-3941727.001.jpg

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