Analysis Of Complications And Risk Factors Of Laparoscopic Adrenalectomy For Adrenal Surgery

Objective:Laparoscopic minimally invasive surgery is the preferred treatment for most adrenal surgical diseases.The overall complication rate of laparoscopic minimally invasive surgery is about 10%.The purpose of this lateral retrospective study was to analyze the complications and risk factors for laparoscopic minimally invasive surgery for adrenal surgery.Methods:From February 1,2012 to June 30,2018,in the database of the First Affiliated Hospital of Nanchang University,a retrospective analysis of 941 patients with adrenal surgery,a total of 952 cases of laparoscopic minimally invasive surgery were collected(including 11 patients who underwent bilateral laparoscopic minimally invasive surgery at least 3 months apart),univariate and multivariate logistic regression analysis were used to analyze the complications and risk factors of laparoscopic minimally invasive surgery for adrenal surgery.Results:80(8.4%)patients had at least one grade ? and above complications of the 952 cases of laparoscopic minimally invasive surgery for adrenal surgery.35(3.68%)patients transfusion therapy was the most common complication event,and one patient(0.25%)died after surgery;7(0.74%)patients required re-surgical intervention for complications,but only one patient required surgical exploration with general anesthesia support;Twelve patients(0.98%)underwent open surgery due to intraoperative complications;15 patients(1.58%)needed to be transferred to the intensive care unit for treatment;7 patients(0.74%)were hospitalized within 30 days after discharge.Multivariate logistic regression analysis showed that ASA-PS grade 3or above(OR: 2.83,[95% CI:1.33-5.51];P=0.032),adrenal pheochromocytoma(OR:4.42,[95% CI: 1.51-13.265];P=0.009)and open laparoscopic surgery(OR: 5.27,[95% CI: 1.81-15.53];P=0.002)is the only independent predictor of overall complication events.Conclusion:ASA-PS grade 3 or 4,adrenal pheochromocytoma and laparoscopic minimally invasive surgery are an independent risk factor for the overall complication of minimally invasive surgery for adrenal surgery.According to this lateral retrospective study,age,obesity,previous abdominal surgery history,and adrenal gland disease side factors may not be risk factors for complications of minimally invasive surgery for adrenal surgery.