Pisarska Magdalena, Dworak Jadwiga, Natkaniec Michał, Małczak Piotr, Przęczek Krzysztof, Wysocki Michał, Major Piotr, Radkowiak Dorota, Budzyński Andrzej, Pędziwiatr Michał
2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.
Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Krakow, Poland.
Wideochir Inne Tech Maloinwazyjne. 2018 Jun;13(2):141-147. doi: 10.5114/wiitm.2018.73357. Epub 2018 Feb 7.
Even though laparoscopic adrenalectomy is currently a standard, there are important variations between different centres in short-term treatment results such as length of hospital stay (LOS) or morbidity.
To determine the factors affecting LOS in patients after laparoscopic transperitoneal lateral adrenalectomy (LTA).
The study enrolled 453 patients (173 men and 280 women, mean age 57 years) who underwent LTA between 2009 and 2017. Discharge from hospital after more than median hospital stay was considered as prolonged LOS. We evaluated factors that potentially may influence LOS (primary length of stay after surgery, excluding readmissions). Logistic regression models were used in univariate and corrected multivariate analyses, in order to identify the factors related to prolonged LOS.
The median LOS after LTA in the studied group was 2 days. One hundred seventy-five (38.5%) patients required prolonged hospitalization. Univariate logistic regression showed that the following factors were related to prolonged LOS: presence of any comorbidity, cardiovascular disease, intraoperative complications, postoperative complications, day of the week of operation (surgery on Thursday or Friday), intraoperative blood loss, need for transfusion, hormonal activity, postoperative drainage, ASA (III-IV) and histological type - pheochromocytoma. Multivariate logistic regression showed that only complications (OR = 3.86; 95% CI: 1.84-8.04), day of the week of operation (Thursday or Friday) (OR = 4.85; 95% CI: 3.04-7.73), need for drainage (OR = 3.63; 95% CI: 1.55-8.52), and histological type - pheochromocytoma (OR = 2.48; 95% CI: 1.35-4.54) prolonged LOS.
Prolonged length of hospital stay following laparoscopic transperitoneal lateral adrenalectomy is strongly associated with the presence of postoperative complications, day of the week of operation (Thursday or Friday), need for drainage, and histological type - pheochromocytoma.
尽管腹腔镜肾上腺切除术目前已成为标准术式，但不同中心在短期治疗结果（如住院时间或发病率）方面仍存在重要差异。
确定影响腹腔镜经腹侧肾上腺切除术（LTA）患者住院时间的因素。
本研究纳入了2009年至2017年间接受LTA的453例患者（173例男性和280例女性，平均年龄57岁）。住院时间超过中位数被视为住院时间延长。我们评估了可能影响住院时间的因素（手术后初次住院时间，不包括再次入院）。采用逻辑回归模型进行单因素和校正多因素分析，以确定与住院时间延长相关的因素。
研究组LTA术后的中位住院时间为2天。175例（38.5%）患者需要延长住院时间。单因素逻辑回归显示，以下因素与住院时间延长相关：存在任何合并症、心血管疾病、术中并发症、术后并发症、手术日（周四或周五）、术中失血、输血需求、激素活性、术后引流、ASA分级（III-IV级）和组织学类型 - 嗜铬细胞瘤。多因素逻辑回归显示，只有并发症（OR = 3.86；95% CI：1.84 - 8.04）、手术日（周四或周五）（OR = 4.85；95% CI：3.04 - 7.73）、引流需求（OR = 3.63；95% CI：1.55 - 8.52）和组织学类型 - 嗜铬细胞瘤（OR = 2.48；95% CI：1.35 - 4.54）会延长住院时间。
腹腔镜经腹侧肾上腺切除术后住院时间延长与术后并发症的存在、手术日（周四或周五）、引流需求和组织学类型 - 嗜铬细胞瘤密切相关。
