Öz Bahadır, Cücük Ömer, Gök Mustafa, Akcan Alper, Sözüer Erdoğan
Department of General Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Clinic of General Surgery, Gaziantep Ersin Arslan Training and Research Hospital, Gaziantep, Turkey.
J Minim Access Surg. 2024 Jan 1;20(1):47-54. doi: 10.4103/jmas.jmas_217_22. Epub 2023 Apr 13.
The present study aimed to evaluate the safety and efficacy of transperitoneal laparoscopic adrenalectomy (LA) for large adrenal tumours by comparing the outcomes of tumours larger than 6 cm with those smaller than 6 cm and also to identify the risk factors associated with prolonged operative time in transperitoneal LA.
One hundred and sixty-three patients underwent LA at our clinic from January 2014 to December 2020. Bilateral LA was performed in 20 of these 163 patients. A total of 143 patients were included in this study. Data were analysed retrospectively from the patients' medical records collected.
Large tumour (LT) group consists of 33 patients and the small tumour (ST) group consists of 110 patients. There was no statistically significant difference between the groups regarding conversion to open surgery and complications. A multiple regression analysis was conducted to identify the independent predictors of prolonged operation time. The tumour size ≥8 cm (odds ratio [OR], 19.132; 95% confidence interval [CI], 3.881-94.303; P < 0.001) and diagnosis of pheochromocytoma (OR, 2.762; 95% CI, (1.123-6.789, P = 0.026) were the significant predictors of prolonged operation time.
Our study shows that LA can be considered the treatment of choice for small and large adrenal tumours. The tumour size ≥8 cm and diagnosis of pheochromocytoma are the independent risk factors for the prolonged operative time in transperitoneal LA.
本研究旨在通过比较直径大于6 cm和小于6 cm的肾上腺肿瘤患者的手术结果,评估经腹腹腔镜肾上腺切除术(LA)治疗大型肾上腺肿瘤的安全性和有效性,并确定经腹LA手术时间延长的相关危险因素。
2014年1月至2020年12月期间,163例患者在我院接受了LA手术。其中163例患者中有20例接受了双侧LA手术。本研究共纳入143例患者。从收集的患者病历中进行回顾性数据分析。
大肿瘤(LT)组33例患者,小肿瘤(ST)组110例患者。两组在转为开放手术和并发症方面无统计学显著差异。进行多元回归分析以确定手术时间延长的独立预测因素。肿瘤大小≥8 cm(比值比[OR],19.132;95%置信区间[CI],3.881 - 94.303;P < 0.001)和嗜铬细胞瘤诊断(OR,2.762;95% CI,1.123 - 6.789,P = 0.026)是手术时间延长的显著预测因素。
我们的研究表明,LA可被视为大小肾上腺肿瘤的首选治疗方法。肿瘤大小≥8 cm和嗜铬细胞瘤诊断是经腹LA手术时间延长的独立危险因素。