BACKGROUND The aims of the present study were to (1) analyse preoperative computed tomography (CT) parameters, (2) investigate whether obesity and CT parameters affect surgical outcomes in patients undergoing LESS lateral retroperitoneal adrenalectomy, and (3) further establish the optimal cutoff point of CT parameters for tolerable operating time. METHODS Between January 2010 and August 2016, patients who underwent LESS adrenalectomy through the retroperitoneal approach in our hospitals were included. Patients' demographic data, preoperatively measured CT parameters (the depth and horizontal width to the adrenal gland in the axial view of abdominal CT, the vertical height in the coronal view of CT, and the angle of the depth and horizontal width), and intraoperative (operative time and blood loss) and postoperative (hospital stay and complications) parameters were retrospectively reviewed. Linear regression was performed to determine factors that potentially affect surgical outcomes. RESULTS In 116 patients, depth was the only CT parameter associated with surgical outcomes. Large depth (P = 0.005; 95% CI 1.739-9.256) and high BMI (P = 0.012; 95% CI 0.357-2.851) were factors significantly associated with longer operative time. The area under the ROC curve for the depth was 0.69 (P = 0.002), and the cutoff point 10.48 cm may be the tolerable operating time. CONCLUSIONS Our results suggest a depth limit of 10.48 cm for the optimal prediction of operating time less than 90 min; although obese patients and deeper adrenal glands had longer operative time, LESS adrenalectomy could be performed in the obese patients without increased blood loss, prolonged hospital stay, or increased pain.

中文翻译：

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术前计算机断层扫描参数和肥胖对腹腔镜单点肾上腺切除术的手术效果的影响。

背景技术本研究的目的是（1）分析术前计算机断层扫描（CT）参数，（2）研究肥胖和CT参数是否影响LESS腹膜后腹膜后肾上腺切除术患者的手术结局，以及（3）进一步确定最佳截止值CT参数的点可容许的工作时间。方法纳入2010年1月至2016年8月在我们医院通过腹膜后入路行LESS肾上腺切除术的患者。患者的人口统计学数据，术前测量的CT参数（在腹部CT轴向视图中至肾上腺的深度和水平宽度，在CT冠状视图中的垂直高度以及深度和水平宽度的角度），回顾性分析了术中（手术时间和失血量）和术后（住院时间和并发症）参数。进行线性回归以确定可能影响手术结果的因素。结果在116例患者中，深度是唯一与手术结果相关的CT参数。大深度（P = 0.005； 95％CI 1.739-9.256）和高BMI（P = 0.012； 95％CI 0.357-2.851）是与更长手术时间显着相关的因素。ROC曲线下深度的面积为0.69（P = 0.002），截止点10.48 cm可能是可容许的工作时间。结论我们的结果表明，对于不到90分钟的最佳手术时间预测，深度限制为10.48厘米。尽管肥胖患者和更深的肾上腺手术时间更长，