The Analysis On Risk Factors Of Postoperative Complications After Retroperitoneoscopic Adrenalectomy And Initial Establishment Of A Predictionscore System

Objective: to explore the risk factors of postoperative complications after retroperitoneoscopic adrenalectomy(RA),and propose an original score system for predicting postoperative complications after RA.Materials and methods: patients who underwent RA between December 2013 and February 2017 in the First Affiliated Hospital of Guangxi Medical University and met the exclusion criteria and the inclusion criteria of the present study were retrospectively analyzed.The risk factors of postoperative complications after RA were assessed utilizing univariable and multivariable logistic regression analysis.On these bases,we initially established a predicting score system for postoperative complications after RA.Results: A total of 254 patients were included,of whom 40(15.7%)developed postoperative complication.By the univariable and multivariable logistic regression analysis: the secretion of cortisol or catecholamine(OR 2.453,95%CI 1.056~5.699,P=0.037),the diameter of adrenal tumor was greater than 6 centimeter(OR 4.449,95%CI 1.129~17.509,P=0.033),the inhomogeneous enhancement of adrenal tumor on enhancement Computed Tomography(CT)(OR 3.033,95%CI 1.399~6.576,P=0.005)and the adrenal tumors press against a major adjacent vessel(OR 2.997,95%CI 1.367~6.572,P=0.006)were the risk factors of complication after RA.The sensitivity to predict postoperative complications of the score system which was set up on the basis of the result of regression analysis was 60.0%,the specificity 85.0%.The high risk group(2~4points)had higher risk for complications,compared to the low risk group(0~1point)(OR=8.531,95%CI 4.088~17.805,P<0.001).Conclusion: Secretion of cortisol and catecholamine,the diameter of greater than 6 centimeter,the inhomogeneous enhancement of adrenal tumor on enhancement CT and pressing against a major adjacent vessel were the risk factors of complications after RA.The score system we had proposed has covered the biochemical function and anatomy factor of the adrenal tumors,and has the potential to help the clinician to differentiate high risk patients of postoperative complications before RA.