肾上腺切除术后静脉血栓栓塞的发生率：一项法国国家外科质量改进计划（CESQIP）分析
Incidence of venous thromboembolism following adrenalectomy: A CESQIP analysis.
作者信息
Sada Alaa, Habermann Elizabeth B, Dy Benzon M, Lyden Melanie L, McKenzie Travis J, Gruber Lucinda M, Foster Trenton R
机构信息
Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Department of Health Services Research, Mayo Clinic, Rochester, MN, USA.
出版信息
Am J Surg. 2024 Feb;228:226-229. doi: 10.1016/j.amjsurg.2023.10.022. Epub 2023 Oct 5.
BACKGROUND
We aim to evaluate the incidence of venous thromboembolism (VTE) following adrenalectomy.
METHODS
A retrospective analysis of the Collaborative Endocrine Surgery Quality Improvement Program was performed to assess incidence for VTE, including pulmonary embolism or deep vein thrombosis, in adults undergoing adrenalectomy (2014-2022).
RESULTS
2567 patients undergoing adrenalectomy were included. Surgical approach was 10% open and 90% minimally invasive. Pathology was 13% malignant and 87% benign; 19% had hypercortisolism. VTE developed in 0.27% at a median of 8 days from surgery. The incidence was higher in primary adrenal malignancy compared to benign or metastases to the adrenals, p < 0.01. VTE was associated with longer hospital stay, longer operative time, readmission, and mortality. VTE rates were similar for hypercortisolism vs no hypercortisolism and between patients with clinical vs subclinical hypercortisolism.
CONCLUSION
Although VTE following adrenalectomy is rare, it is more common in cases of primary adrenal malignancy, those with longer operations, or those requiring prolonged hospitalization.
背景
我们旨在评估肾上腺切除术后静脉血栓栓塞症（VTE）的发生率。
方法
对协作内分泌外科质量改进项目进行回顾性分析，以评估2014年至2022年接受肾上腺切除术的成年人发生VTE（包括肺栓塞或深静脉血栓形成）的发生率。
结果
纳入了2567例接受肾上腺切除术的患者。手术方式为10%开放手术和90%微创手术。病理结果为13%恶性和87%良性；19%患有皮质醇增多症。VTE发生率为0.27%，中位发生时间为术后8天。原发性肾上腺恶性肿瘤患者的VTE发生率高于肾上腺良性肿瘤或肾上腺转移瘤患者，P<0.01。VTE与住院时间延长、手术时间延长、再次入院和死亡率相关。皮质醇增多症患者与无皮质醇增多症患者以及临床皮质醇增多症与亚临床皮质醇增多症患者之间的VTE发生率相似。
结论
虽然肾上腺切除术后VTE很少见，但在原发性肾上腺恶性肿瘤、手术时间较长或需要长期住院的患者中更常见。
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