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目的探讨体质指数(body mass index BMI)对后腹腔镜下肾上腺肿瘤切除术的操作及术后恢复的影响。方法回顾性分析2014年9月到2015年12月行后腹腔镜下肾上腺肿瘤切除术的60例患者的临床资料,除1例因下腔静脉出血中转开放手术外,其余59例均顺利完成手术,依据BMI分为超重组(BMI≥25)26例(男/女=14/12),非超重组(BMI<25)33例(男/女=17/16)。分别比较两组手术时间、术中出血量、术后住院天数、留置引流管时间及引流量、术后并发症和术后视觉模拟疼痛评分(VAS)。结果完成后腹腔镜下肾上腺手术的59例患者中,超重组肿瘤直径0.8~5.4 cm,非超重组肿瘤直径1.0~5.8 cm。两组在术后住院天数、留置引流管时间及其引流量、术后并发症发生率、术后VAS评分方面比较差异无统计学意义(P均>0.05);超重组和非超重组手术时间分别为(62.1±19.3)min和(42.8±11.3)min;术中出血量分别为(89.6±15.8)ml和(72.0±16.4)ml,超重组均高于非超重组,差异有统计学意义(P均<0.01)。结论对于行后腹腔镜下肾上腺肿瘤切除术患者,BMI的增加将增加手术时间、术中出血量,对术后恢复、术后镇痛和术后并发症无明显影响。
Objective To investigate the effect of body mass index (BMI) on the operation and postoperative recovery of retroperitoneal laparoscopic adrenalectomy. Methods The clinical data of 60 patients who underwent laparoscopic retroperitoneal adrenalectomy from September 2014 to December 2015 were retrospectively analyzed. Except for one case, the operation was performed in 1 case because of the inferior vena cava hemorrhage and the other 59 cases were successfully performed According to BMI, 26 cases (M / F = 14/12) and 33 cases (M / F = 17/16) of non-overweight group (BMI <25) were enrolled in the study. The operation time, intraoperative blood loss, postoperative hospital stay, indwelling drainage tube time and drainage volume, postoperative complications and postoperative visual analogue pain score (VAS) were compared. Results After completion of laparoscopic adrenalectomy in 59 patients, overweight group tumor diameter 0.8 ~ 5.4 cm, non-overweight group tumor diameter 1.0 ~ 5.8 cm. There was no significant difference in postoperative hospital stay, indwelling drainage tube time, drainage volume, incidence of postoperative complications and postoperative VAS score between the two groups (all P> 0.05); the operation time of overweight group and non-overweight group (62.1 ± 19.3) min and (42.8 ± 11.3) min, respectively. The blood loss in operation was (89.6 ± 15.8) ml and (72.0 ± 16.4) ml, respectively, which were significantly higher in overweight group than those in non-overweight group (P <0.01). Conclusions For patients undergoing retroperitoneal laparoscopic adrenalectomy, the increase of BMI will increase the operation time and intraoperative blood loss, and have no significant effect on postoperative recovery, postoperative analgesia and postoperative complications.