Prolonged operative time in laparoscopic appendectomy: Predictive factors and outcomes
Prolonged operative time in laparoscopic appendectomy: Predictive factors and outcomes
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DOI：
10.1016/j.ijsu.2016.10.035
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发表时间：
2016-12-01
影响因子：
15.3
通讯作者：
Lee, Sang-Jeon
中科院分区：
文献类型：
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作者：
Jeon, Byeong Geon;Kim, Hyuk Jung;Lee, Sang-Jeon
简介：据我们所知，这项研究是第一个确定与腹腔镜阑尾切除术相关的手术时间延长的预测因素和结果。我们的目的是确定影响手术时间的术前因素，并确定手术时间如何影响腹腔镜阑尾切除术outcome.Methods：回顾性分析了2008年1月至2014年12月期间接受腹腔镜阑尾切除术的3049例患者的病历。根据分布情况，手术时间延长定义在前10%中（> 90分钟）。建立了一个多变量回归模型来评估潜在的预测因素和手术时间延长的结果。在非穿孔性阑尾炎的腹腔镜阑尾切除术中，通过多变量分析确定的预测手术时间延长的独立因素是C反应蛋白水平升高，症状持续时间超过3天，和计算机断层扫描结果表明阑尾直径超过10 mm。在腹腔镜阑尾切除术穿孔阑尾炎，超重，C反应蛋白升高，症状持续时间超过3天，脓肿的CT表现是手术时间延长的独立预测因素。手术时间延长会增加并发症、住院时间延长和再入院的风险。结论：超重、C反应蛋白升高、症状持续时间超过3天、阑尾直径超过10 mm和脓肿是手术时间延长的独立预测因素。此外，手术时间延长与腹腔镜阑尾切除术后的不良术后结局相关。(C)2016年IJS出版集团有限公司由爱思唯尔有限公司出版。版权所有。
Introduction: To our knowledge, this study is the first to identify the predictive factors and outcomes of prolonged operative time associated with laparoscopic appendectomy. We aimed to identify preoperative factors that influence operation time and to determine how operative time affects laparoscopic appendectomy outcomes.Methods: The medical records of 3049 patients who had undergone laparoscopic appendectomy between January 2008 and December 2014 were retrospectively reviewed. Prolonged operative time was defined in the top 10% according to distribution (> 90 min). A multivariate regression model was generated to assess potential predictive factors and outcomes of prolonged operative time.Results: In laparoscopic appendectomy for non-perforated appendicitis, independent factors that predict a prolonged operative time as identified through multivariate analysis were elevated C-reactive protein levels, symptom duration of more than 3 days, and computed tomography findings indicating an appendiceal diameter of more than 10 mm. In laparoscopic appendectomy for perforated appendicitis, overweight, elevated C-reactive protein, symptom duration of more than 3 days, and computed tomography findings of abscess were independent predictive factors for prolonged operative time. Prolonged surgery increases the risk of complications, prolonged hospital stay, and readmission.Conclusions: Overweight, elevated C-reactive protein, symptom duration of more than 3 days, appendiceal diameter of more than 10 mm, and abscess were independent predictive factors of prolonged operative time. Furthermore, prolonged operative time was associated with adverse postoperative outcomes after laparoscopic appendectomy. (C) 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.