Patients criteria determining difficulty of the laparoscopic lateral transperitoneal adrenalectomy. A retrospective cohort study

Natkaniec, Michał; Dworak, Jadwiga; Pędziwiatr, Michał; Pisarska, Magdalena; Major, Piotr; Dembiński, Marcin; Winiarski, Marek; Budzyński, Andrzej

doi:10.1016/j.ijsu.2017.05.032

“…Previous studies con rm that the elderly, obese patients and male gender are associated with longer operative time. [11,12,15] However, this study reported that there is no signi cant difference in terms of age, sex, and BMI between low-di culty and high-di culty groups of ACSS.…”

Section: Discussioncontrasting

confidence: 56%

“…Researchers have established several scoring systems for assessing the surgical di culty. Natkaniec et al [11] demonstrated that gender, tumor size, and localization are some of the parameters associated with the level of the surgical di culty of the laparoscopic lateral transperitoneal adrenalectomy. Hasegawa et al [12] established a novel model for the prediction of surgical di culty in laparoscopic liver resection and included factors such as the extension of resection, location of tumor, obesity and platelet count.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, due to lack of a gold standard to estimate for surgical di culty, surrogate indicators are often used to indirectly re ect the di culty and these include operative time, intraoperative blood loss and incidence of complication. [11][12][13][14] High-di culty ACSS has been correlated with longer operative time and more intraoperative bleeding.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Establishment of a Nomogram for Predicting the Surgical Difficulty of Anterior Cervical Spine Surgery

Ji

¹

,

Rong

²

,

Wang

³

et al. 2021

Preprint

0

View full text Add to dashboard Cite

Background. For a long time, surgical difficulty is mainly evaluated based on subjective perception rather than objective indexes. Moreover, the lack of systematic research regarding the evaluation of surgical difficulty potentially has a negative effect in this field. This study was aimed to evaluate the risk factors for the surgical difficulty of anterior cervical spine surgery (ACSS).Methods. This was a retrospective cohort study totaling 291 consecutive patients underwent ACSS from 2012.3 to 2017.8. The surgical difficulty of ACSS was defined by operation time longer than 120 min or intraoperative blood loss equal to or greater than 200ml. Evaluation of risk factors was performed by analyzing the patient’s medical records and radiological parameters such as age, sex, BMI, number of operation levels, high signal intensity of spinal cord on T2-weighted images, ossified posterior longitudinal ligament (OPLL), sagittal and coronal cervical circumference, cervical length, spinal canal occupational ratio, coagulation function index and platelet count.Results. Significant differences were reported between low-difficulty and high-difficulty ACSS groups in terms of age (p=0.017), sex (p=0.006), number of operation levels (p<0.001), high signal intensity (p<0.001), OPLL (p<0.001) and spinal canal occupational ratio (p<0.001). Multivariate logistic regression analysis revealed that number of operation levels (OR=5.224, 95%CI=2.125-12.843, p<0.001), high signal intensity of spinal cord (OR=4.994, 95%CI=1.636-15.245, p=0.005), OPLL (OR=6.358, 95%CI=1.932-20.931, p=0.002) and the spinal canal occupational ratio>0.45 (OR=3.988, 95%CI=1.343-11.840, p=0.013) were independently associated with surgical difficulty in ACSS. A nomogram was established and ROC curve gave a 0.906 C-index. There was a good calibration curve for difficulty estimation.Conclusion. This study indicated that the operational level, OPLL, high signal intensity of spinal cord, and spinal canal occupational ratio were independently associated with surgical difficulty and a predictive nomogram can be established using the identified risk factors. Optimal performance was achieved for predicting surgical difficulty of ACSS based on preoperative factors.

show abstract

“…Previous studies con rm that the elderly, obese patients and male gender are associated with longer operative time. [11,12,15] However, this study reported that there is no signi cant difference in terms of age, sex, and BMI between low-di culty and high-di culty groups of ACSS. Coagulation function index and platelet count are associated with intraoperative hemorrhage, however, no statistical signi cance in these factors was reported in our study.…”

Section: Discussioncontrasting

confidence: 56%

Establishment of a Nomogram for Predicting the Surgical Difficulty of Anterior Cervical Spine Surgery

Ji

¹

,

Rong

²

,

Wang

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background. For a long time, surgical difficulty is mainly evaluated based on subjective perception rather than objective indexes. Moreover, the lack of systematic research regarding the evaluation of surgical difficulty potentially has a negative effect in this field. This study was aimed to evaluate the risk factors for the surgical difficulty of anterior cervical spine surgery (ACSS).Methods. This was a retrospective cohort study totaling 291 consecutive patients underwent ACSS from 2012.3 to 2017.8. The surgical difficulty of ACSS was defined by operation time longer than 120 min or intraoperative blood loss equal to or greater than 200ml. Evaluation of risk factors was performed by analyzing the patient’s medical records and radiological parameters such as age, sex, BMI, number of operation levels, high signal intensity of spinal cord on T2-weighted images, ossified posterior longitudinal ligament (OPLL), sagittal and coronal cervical circumference, cervical length, spinal canal occupational ratio, coagulation function index and platelet count.Results. Significant differences were reported between low-difficulty and high-difficulty ACSS groups in terms of age (p=0.017), sex (p=0.006), number of operation levels (p<0.001), high signal intensity (p<0.001), OPLL (p<0.001) and spinal canal occupational ratio (p<0.001). Multivariate logistic regression analysis revealed that number of operation levels (OR=5.224, 95%CI=2.125-12.843, p<0.001), high signal intensity of spinal cord (OR=4.994, 95%CI=1.636-15.245, p=0.005), OPLL (OR=6.358, 95%CI=1.932-20.931, p=0.002) and the spinal canal occupational ratio>0.45 (OR=3.988, 95%CI=1.343-11.840, p=0.013) were independently associated with surgical difficulty in ACSS. A nomogram was established and ROC curve gave a 0.906 C-index. There was a good calibration curve for difficulty estimation.Conclusion. This study indicated that the operational level, OPLL, high signal intensity of spinal cord, and spinal canal occupational ratio were independently associated with surgical difficulty and a predictive nomogram can be established using the identified risk factors. Optimal performance was achieved for predicting surgical difficulty of ACSS based on preoperative factors.

show abstract

“…Our department is a tertiary referral university unit. Annually more than 700 laparoscopic procedures are performed – mainly gastric, bariatric, colorectal, pancreatic and hepatobiliary surgeries, with more than 60 cases of adrenalectomy [ 9 , 10 ]. Since 2003 a laparoscopic approach has been the preferred access for adrenalectomy in our unit.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for prolonged hospitalization in patients undergoing laparoscopic adrenalectomy.

Pisarska

¹

,

Dworak

²

,

Natkaniec

³

et al. 2018

Videosurgery and Other Miniinvasive Techniques

Self Cite

View full text Add to dashboard Cite

IntroductionEven 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.AimTo determine the factors affecting LOS in patients after laparoscopic transperitoneal lateral adrenalectomy (LTA).Material and methodsThe 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.ResultsThe 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.ConclusionsProlonged 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.

show abstract

Patients criteria determining difficulty of the laparoscopic lateral transperitoneal adrenalectomy. A retrospective cohort study

Cited by 17 publications

References 30 publications

Establishment of a Nomogram for Predicting the Surgical Difficulty of Anterior Cervical Spine Surgery

Establishment of a Nomogram for Predicting the Surgical Difficulty of Anterior Cervical Spine Surgery

Establishment of a Nomogram for Predicting the Surgical Difficulty of Anterior Cervical Spine Surgery

Risk factors for prolonged hospitalization in patients undergoing laparoscopic adrenalectomy.

Contact Info

Product

Resources

About