Risk Factors For Postoperative Chemosis In Patients Undergoing Retroperitoneal Laparoscopic Surgery

Objective:To analyze the risk factors of chemosis after retroperitoneal laparoscopic surgery.Methods:Clinical data of patients undergoing retroperitoneal laparoscopic urological surgery in the First Hospital of Shanxi Medical University from September 2018 to December2019 were collected.According to whether there was chemosis or not,the patients were divided into two groups.Univariate and multivariate Logistic regression analysis was performed on the relevant data of the patients,ROC curve was drawn and area under the curve was calculated.Results:Postoperative chemosis occurred in 85 of 825 patients（10.3%）.Single factor analysis showed that compared with the control group,chemosis group of age on the high side,kidney cancer accounts for a strikingly higher than surgery,intraoperative blood loss,transfusion volume increased significantly,the knife head low Angle increases,the operation time significantly extended,pneumoperitoneum pressure,5 min after endotracheal intubation,side knife after 5 min,restore the hypothesis before and after the end of pp,and restore the hypothesis 5 min P_ETCO₂increased significantly（P<0.05）.Logistic regression analysis showed:low head Angle（OR=2.967,95%CI:1.825-4.826 P<0.001）,operation time（OR=30.673,95%CI:3.861-243.676,P=0.001）,pneumoperitoneal pressure（OR=8.371,95%CI:3.126-22.418,P<0.001）,P_ETCO₂（OR=1.931,95%CI:1.453-2.565,P<0.001）was an independent risk factor for postoperative bulbous conjunctival edema.ROC curve analysis shows that:Head low Angle（area under the curve is 0.744,P<0.001,the 0.624 sensitivity and degree is0.765）,operation time,the area under the curve（0.868,P<0.001,0.882 sensitivity and degree is 0.724）,pneumoperitoneum pressure（area under curve of 0.855,P<0.001,0.765 sensitivity and degree is 0.818）,side folding knife after 5 minpetco2（area under curve of 0.818,P<0.001,0.906 sensitivity and degree is 0.612）was effective in diagnosing postoperative chemosis.Conclusion:large head Angle,high pneumoperitoneum pressure and high P_ETCO₂5 minute after lateral decubitus position are independent risk factors for chemosis after laparoscopic urological surgery.