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肥胖对腹腔镜经腹腔肾上腺切除术的影响。

The effect of obesity in laparoscopic transperitoneal adrenalectomy.

作者信息

Altın Önder, Sarı Ramazan

机构信息

Clinic of General Surgery, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey.

出版信息

Turk J Surg. 2021 Jun 30;37(2):126-132. doi: 10.47717/turkjsurg.2021.4901. eCollection 2021 Jun.

Abstract

OBJECTIVES

Laparoscopic adrenalectomy is the gold standard for the resection of adrenal tumors. However, there are some technical difficulties, which may be due to the fact that adrenalectomy is rarely encountered in general surgery practice and has a high learning curve. In addition to these, obesity is another problem in laparoscopic adrenalectomies. In the present study, it was aimed to evaluate whether obesity affects perioperative and postop- erative complications after laparoscopic adrenalectomy.

MATERIAL AND METHODS

This is a retrospective comparative study carried out between December 2008 and June 2018. A total of 65 patients who un- derwent laparoscopic transperitoneal adrenalectomy were divided into two groups according to their Body Mass Index (BMI). Patients' demographic data, perioperative and postoperative results were analyzed from hospital medical records.

RESULTS

There were 30 non-obese and 35 obese patients. There was no significant difference between obese and non-obese patients in terms of op- eration time, peroperative complications and length of hospital stay. However, there was a statistically significant difference between the two groups for postoperative complications (p <0.031). There was conversion to open surgery in four obese patients and in one patient in the non-obese group.

CONCLUSION

In obese patients, technical difficulties may be encountered during surgery due to increased adipose tissue, and postoperative complica- tion rates may increase. Nevertheless, laparoscopic transperitoneal adrenalectomy can be performed safely paying attention to the management of obesity-related complications.

摘要

目的

腹腔镜肾上腺切除术是肾上腺肿瘤切除的金标准。然而,存在一些技术难题,这可能是由于肾上腺切除术在普通外科实践中很少遇到且学习曲线较陡。除此之外,肥胖是腹腔镜肾上腺切除术中的另一个问题。在本研究中,旨在评估肥胖是否会影响腹腔镜肾上腺切除术后的围手术期和术后并发症。

材料与方法

这是一项于2008年12月至2018年6月间进行的回顾性对照研究。总共65例行腹腔镜经腹肾上腺切除术的患者根据其体重指数(BMI)分为两组。从医院病历中分析患者的人口统计学数据、围手术期和术后结果。

结果

有30例非肥胖患者和35例肥胖患者。肥胖患者和非肥胖患者在手术时间、术中并发症和住院时间方面无显著差异。然而,两组在术后并发症方面存在统计学显著差异(p<0.031)。4例肥胖患者和1例非肥胖组患者中转开腹手术。

结论

在肥胖患者中,由于脂肪组织增加,手术期间可能会遇到技术难题,且术后并发症发生率可能会增加。尽管如此,注意肥胖相关并发症的处理,腹腔镜经腹肾上腺切除术仍可安全进行。

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