Department of Urology, ShengJing Hospital of China Medical University, Shenyang, 110004, China.
Department of Urology, ShengJing Hospital of China Medical University, Shenyang, 110004, China.
Int J Surg. 2018 Dec;60:188-193. doi: 10.1016/j.ijsu.2018.11.019. Epub 2018 Nov 20.
Surgical resection is the primary treatment strategy for pheochromocytoma; however, it carries a high risk of morbidity and mortality. The risk factors for severe morbidity remain unclear and require further exploration. We aimed to identify the risk factors for severe morbidity after pheochromocytoma surgery in Chinese patients.
We retrospectively reviewed 262 patients who underwent unilateral laparoscopic or open pheochromocytoma surgery at our center between January 1, 2007 and December 31, 2016. Patient demographics, as well as extensive perioperative data were recorded. Adjusted odds ratios and 95% confidence intervals were determined by multivariate binary logistic regression. Cutoff values and the area under the curve for continuous risk factors were calculated through receiver operating characteristic curve analysis. A P < 0.05 was considered statistically significant.
Of the 262 patients, 78 (29.8%) had severe morbidity. The independent risk factors for severe morbidity were female sex, lower body mass index, coronary heart disease, longer duration of surgery, and intraoperative hemodynamic instability, with odds ratios of 2.624 (P = 0.003), 0.780 (P < 0.001), 2.098, (P = 0.024), 1.005 (P = 0.031), and 2.920 (P = 0.005). The optimal cut off values for body mass index and duration of surgery were 24.25 kg/m and 203 min.
Severe morbidity is common in patients after pheochromocytoma surgery. We identified five independent risk factors for severe morbidity: female sex, lower body mass index, coronary heart disease, longer duration of surgery, and intraoperative hemodynamic instability. Identification of these risk factors may help to improve perioperative strategy.
手术切除是嗜铬细胞瘤的主要治疗策略，但它存在很高的发病率和死亡率风险。严重发病率的危险因素仍不清楚，需要进一步探讨。我们旨在确定中国患者嗜铬细胞瘤手术后严重发病率的危险因素。
我们回顾性分析了 2007 年 1 月 1 日至 2016 年 12 月 31 日期间在我院接受单侧腹腔镜或开放性嗜铬细胞瘤手术的 262 例患者。记录患者的人口统计学特征以及广泛的围手术期数据。通过多变量二元逻辑回归确定调整后的优势比和 95%置信区间。通过受试者工作特征曲线分析计算连续危险因素的截断值和曲线下面积。P 值<0.05 被认为具有统计学意义。
在 262 例患者中，78 例（29.8%）发生严重发病率。女性、较低的体重指数、冠心病、手术时间较长和术中血流动力学不稳定是严重发病率的独立危险因素，优势比分别为 2.624（P=0.003）、0.780（P<0.001）、2.098（P=0.024）、1.005（P=0.031）和 2.920（P=0.005）。体重指数和手术时间的最佳截断值分别为 24.25kg/m和 203min。
嗜铬细胞瘤手术后患者的严重发病率较高。我们确定了五个与严重发病率相关的独立危险因素：女性、较低的体重指数、冠心病、手术时间较长和术中血流动力学不稳定。识别这些危险因素可能有助于改善围手术期策略。
