PMID- 34534705
OWN - NLM
STAT- MEDLINE
DCOM- 20211111
LR  - 20230302
IS  - 1743-9159 (Electronic)
IS  - 1743-9159 (Linking)
VI  - 94
DP  - 2021 Oct
TI  - New predictive factors for prolonged operation time of laparoscopic posterior 
      retroperitoneal adrenalectomy; retrospective cohort study.
PG  - 106113
LID - 10.1016/j.ijsu.2021.106113 [doi]
AB  - BACKGROUND: Laparoscopic adrenalectomy is a standard surgical procedure for 
      benign adrenal diseases. Laparoscopic posterior retroperitoneal adrenalectomy 
      (LPRA) has many benefits. However, it is associated with factors such as prolong 
      operation time. The aim of the study was to determine the predictive factors 
      associated with prolonged operation time in LPRA. MATERIALS AND METHODS: This 
      study retrospectively analyzed data from 284 patients who underwent LPRA between 
      2014 and 2019 at Asan Medical Center. Then, we analyzed the predictive factors 
      prolonging operation time using multivariate logistic regression analysis and 
      classified the differences according to the learning curve using cumulative sum 
      analysis. RESULTS: In multivariate logistic regression analysis, the following 
      were determined as factors associated with prolonged operation time: male sex 
      (OR, 2.540; 95% CI, 1.225-5.266), pheochromocytoma (OR, 3.669; 95% CI, 
      1.548-8.694), right site (OR, 2.499; 95% CI, 1.086-5.748), surgeon A (OR, 3.293; 
      95% CI, 1.522-7.122), depth of descended adrenal tumor location to kidney (OR, 
      3.793; 95% CI, 1.660-8.667), large periadrenal fat volume (OR, 2.366; 95% CI, 
      1.120-4.996), and posterior adiposity index (PAI) (OR, 2.171; 95% CI, 
      1.090-4.324) (all p < 0.05). However, in the period after the learning curve, 
      periadrenal fat volume was not a significant predictor of surgery time 
      prolongation. CONCLUSION: This study demonstrates that depth of descended adrenal 
      tumor location to kidney is a new and important independent predictive factor for 
      prolonged operation time in LPRA. In addition, periadrenal fat volume is a 
      predictor of surgery time prolongation for beginner surgeons before the learning 
      curve.
CI  - Copyright (c) 2021 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights 
      reserved.
FAU - Rah, Cheong-Sil
AU  - Rah CS
AD  - Department of Surgery, Asan Medical Center, University of Ulsan College of 
      Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea Department 
      of Surgery, Uijeongbu Eulji Medical Center, Eulji University, 712, Dongil-ro, 
      Uijeongbu-si, Gyeonggi-do, 11759, South Korea Division of Endocrinology and 
      Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 
      88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
FAU - Kim, Won Woong
AU  - Kim WW
FAU - Lee, Yu-Mi
AU  - Lee YM
FAU - Chung, Ki-Wook
AU  - Chung KW
FAU - Koh, Jung-Min
AU  - Koh JM
FAU - Lee, Seung Hun
AU  - Lee SH
FAU - Hong, Suck Joon
AU  - Hong SJ
FAU - Sung, Tae-Yon
AU  - Sung TY
LA  - eng
PT  - Journal Article
DEP - 20210914
PL  - United States
TA  - Int J Surg
JT  - International journal of surgery (London, England)
JID - 101228232
SB  - IM
CIN - Int J Surg. 2022 Feb;98:106213. PMID: 34999000
MH  - *Adrenal Gland Neoplasms/surgery
MH  - Adrenalectomy
MH  - Humans
MH  - *Laparoscopy
MH  - Male
MH  - Retroperitoneal Space/surgery
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Adrenalectomy
OT  - Laparoscopy
OT  - Learning curve
OT  - Operation time
OT  - Retroperitoneal space
EDAT- 2021/09/18 06:00
MHDA- 2021/11/12 06:00
CRDT- 2021/09/17 20:15
PHST- 2021/04/14 00:00 [received]
PHST- 2021/08/29 00:00 [revised]
PHST- 2021/09/11 00:00 [accepted]
PHST- 2021/09/18 06:00 [pubmed]
PHST- 2021/11/12 06:00 [medline]
PHST- 2021/09/17 20:15 [entrez]
AID - 01279778-202110000-00011 [pii]
AID - 10.1016/j.ijsu.2021.106113 [doi]
PST - ppublish
SO  - Int J Surg. 2021 Oct;94:106113. doi: 10.1016/j.ijsu.2021.106113. Epub 2021 Sep 
      14.