Introduction: Obesity is usually considered a risk factor for surgical complications. Laparoscopic adrenalectomy has replaced open adrenalectomy as the standard operation for adrenal tumors. Objective: To compare the safety of laparoscopic adrenalectomy to treat adrenal tumors in obese versus nonobese patients. Methods: This observational cohort study analyzed consecutive patients who underwent laparoscopic adrenalectomy with a lateral transperitoneal approach at a single center (2003–2020). Data and outcomes of obese (body mass index ≥30 kg/m²) and nonobese patients were compared. To analyze the association between operative time and other variables, we used simple and multivariate linear regression. Results: N = 160 (90 obese/70 nonobese) patients underwent laparoscopic adrenalectomy. Cushing syndrome and pheochromocytoma were the most frequent indications. Obese patients were older (58 vs. 52 years, p #x3c; 0.001). A greater proportion of obese patients were ASA grade III + IV (71.1 vs. 48.6%, p = 0.004). Obesity was associated with a longer operative time (72.5 vs. 60 min, p #x3c; 0.001) and greater blood loss (40 vs. 20 mL, p = 0.022). There were no differences in conversion, morbidity, or hospital stay. After adjustment for confounding factors, operative time was positively correlated with BMI ≥30 kg/m², learning curve, estimated blood loss, 2D laparoscopy, and specimen size. Conclusion: Lateral transperitoneal laparoscopic adrenalectomy is safe in patients with a BMI 30–35 kg/m², so these patients also benefit from this minimally invasive surgery.
Dig Surg

中文翻译：

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腹腔镜肾上腺切除术中肥胖和非肥胖患者的结果比较：一项队列研究

简介：肥胖通常被认为是手术并发症的危险因素。腹腔镜肾上腺切除术已取代开放式肾上腺切除术成为肾上腺肿瘤的标准手术。目的：比较腹腔镜肾上腺切除术治疗肥胖与非肥胖患者肾上腺肿瘤的安全性。方法：这项观察性队列研究分析了在单中心（2003-2020 年）接受横向经腹膜入路腹腔镜肾上腺切除术的连续患者。比较肥胖（体重指数≥30 kg/m ²）和非肥胖患者的数据和结果。为了分析手术时间与其他变量之间的关联，我们使用了简单和多元线性回归。结果： N= 160 名（90 名肥胖/70 名非肥胖）患者接受了腹腔镜肾上腺切除术。库欣综合征和嗜铬细胞瘤是最常见的适应症。肥胖患者年龄较大（58 岁与 52 岁，p #x3c；0.001）。更大比例的肥胖患者为 ASA III + IV 级（71.1 对 48.6%，p = 0.004）。肥胖与更长的手术时间（72.5 与 60 分钟，p #x3c；0.001）和更大的失血量（40 与 20 毫升，p = 0.022）相关。在转化率、发病率或住院时间方面没有差异。调整混杂因素后，手术时间与BMI≥30 kg/m ²、学习曲线、估计失血量、二维腹腔镜检查和标本大小呈正相关。结论：横向经腹腹腔镜肾上腺切除术对于 BMI 30-35 kg/m ^{2 的}患者是安全的，因此这些患者也受益于这种微创手术。
挖掘外科