Factors Associated with Prolonged Retroperitoneal Laparoscopic Radical Nephrectomy Performed by Non-expert Surgeons
Factors Associated with Prolonged Retroperitoneal Laparoscopic Radical Nephrectomy Performed by Non-expert Surgeons
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DOI：
10.1272/jnms.jnms.2021_88-302
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发表时间：
2021-04-01
影响因子：
1
通讯作者：
Kondo, Yukihiro
中科院分区：
文献类型：
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作者：
Yanagi, Masato;Kimura, Go;Kondo, Yukihiro
背景资料：据报道，高体重指数（BMI）和内脏肥胖与经腹膜腹腔镜根治性肾切除术（LRN）时间延长有关;然而，延长腹膜后LRN的因素仍不清楚。因此，我们调查的因素与长期腹膜后LRN由non-expert surgery.Methods进行：我们定义的非专家的外科医生没有认证的外科医生进行腹腔镜手术的日本腔内泌尿外科学会。我们回顾性分析了2014年至2019年期间在我院接受非专家进行的腹膜后LRN治疗的59例连续肾癌患者的病历。手术时间与年龄、性别、BMI、内脏脂肪面积（VFA）、皮下脂肪面积（SFA）、肿瘤的偏侧性和位置、肿瘤长轴长度的关系采用斯皮尔曼等级相关系数分析肿瘤长度、临床T分期、同侧肾上腺切除术和标本重量。手术时间与同侧肾上腺切除术正相关（rs = 0.3162，p = 0.0147）和样本重量（rs = 0.3103，p = 0.0168），但与BMI无关（rs = 0.2016，p = 0.1257）或VFA结论：非专业外科医生施行同侧肾上腺切除术和标本重量与腹膜后LRN延长相关。
Background: High body mass index (BMI) and visceral obesity were reported to be associated with prolonged transperitoneal laparoscopic radical nephrectomy (LRN); however, factors that prolong retroperitoneal LRN remain unknown. We therefore investigated factors associated with prolonged retroperitoneal LRN performed by non-expert surgeons.Methods: We defined non-experts surgeons as surgeons not certified to perform laparoscopic surgery by the Japanese Society of Endourology. We retrospectively reviewed the medical records of 59 consecutive patients with renal cell carcinoma treated with retroperitoneal LRN performed by non-experts at our hospital between 2014 and 2019. Associations of surgical duration with age, sex, BMI, visceral fat area (VFA), subcutaneous fat area (SFA), laterality and location of the tumor, length of the major tumor axis (tumor length), clinical T stage, ipsilateral adrenalectomy and specimen weight were analyzed using Spearman rank correlation coefficients.Results: Surgical duration positively correlated with ipsilateral adrenalectomy (rs = 0.3162, p = 0.0147) and specimen weight (rs = 0.3103, p = 0.0168) but not with BMI (rs = 0.2016, p = 0.1257) or VFA (rs = 0.0185, p = 0.8894).Conclusions: Ipsilateral adrenalectomy and specimen weight were associated with prolonged retroperitoneal LRN, when performed by non-expert surgeons.