Side-specific factors for intraoperative hemodynamic instability in laparoscopic adrenalectomy for pheochromocytoma: a comparative study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Habeeb Tamer A A M, Araujo-Castro Marta, Chiaretti Massimo, Podda Mauro, Aiolfi Alberto, Kryvoruchko Igor A, Manangi Mallikarjuna N, Shelat Vishal, Kalmoush Abd-Elfattah, Labib Mohamed Fathy, Elshafey Mohammed Hassan, Ibrahim Sameh Mohamed Mahmoud, Abo Alsaad Mohamed Ibrahim, Elbelkasi Hamdi, Mansour Mohamed Ibrahim, Elshahidy Tamer Mohamed, Heggy Ibrahim A, Elsayed Rasha S, Fiad Alaa A, Yehia Ahmed M, Yassin Mahmoud Abdou, Elballat Mahmoud R, Hebeishy Mohamed H, AboZeid Ahmed Khaled, Saleh Mohamed Adel Ahmed, Hamed Abd Elwahab M, Abdelghani Amr A, Mousa Bassam
Аннотация
METHODS: We retrospectively analyzed two hundred and seventy-one patients aged > 18 years with unilateral benign PHEO of any size who underwent transperitoneal laparoscopic adrenalectomy at our hospitals between September 2016 and September 2023. Patients were divided into LRA (N = 122) and LLA (N = 149) groups. Univariate and multivariate logistic regression analyses were used to predict intraoperative HDI. In multivariate analysis for the prediction of HDI, right-sided PHEO, PHEO size, preoperative comorbidities, and preoperative systolic blood pressure were included.
RESULTS: Intraoperative HDI was significantly higher in the LRA group than in the LLA (27% vs. 9.4%, p < 0.001). In the multivariate regression analysis, right-sided tumours showed a higher risk of intraoperative HDI (odds ratio [OR] 5.625, 95% confidence interval [CI], 1.147-27.577, p = 0.033). The tumor size (OR 11.019, 95% CI 3.996-30.38, p < 0.001), presence of preoperative comorbidities [diabetes mellitus, hypertension, and coronary heart disease] (OR 7.918, 95% CI 1.323-47.412, p = 0.023), and preoperative systolic blood pressure (OR 1.265, 95% CI 1.07-1.495, p = 0.006) were associated with a higher risk of HDI in both LRA and LLA, with no superiority of one side over the other.
CONCLUSION: LRA was associated with a significantly higher intraoperative HDI than LLA. Right-sided PHEO was a risk factor for intraoperative HDI.