M. Artykov, H. B. Haberal, Ö. F. Bahadır, A. Güdeloğlu, B. Akdogan, F. Aki, C. Bilen, S. Yazıcı
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引用次数: 0
Abstract
Objective: To determine which preoperative patient characteristics are predictive of intraoperative complications (IOC) and postoperative complications (POC) in patients undergoing nephrectomy for non-oncological diseases. Materials and Methods: Demographics, pre-operative characteristics, the surgical technique and perioperative outcomes of 295 adult patients who had underwent simple nephrectomy between 2002 and 2019 in a single reference institution were analyzed retrospectively. Univariate and multivariable statistical analyses were performed to determine the factors affecting POC (Clavien-Dindo score ≥1) and IOC. All statistical analyses were performed using the Statistical Package for the Social Sciences v. 24.0 (SPSS Inc., Chicago, IL, USA) software for Windows. Results: The mean age of the patients was 44.84±15.51 years, with a female-to-male ratio of 154/141. The statistically significant factors associated with IOC in the multivariable analysis were male gender, higher American Society of Anesthesiologists (ASA) score and urgent surgical intervention (p=0.002, p=0.001, p=0.021, respectively). In multivariable analysis, preoperative anemia, emergency surgery and open surgery were found to be statistically significant and associated with POC (p<0.001, p=0.004, and p=0.049, respectively). Conclusion: Improved surgical outcomes can be achieved through treatment adapted to individual preoperative characteristics such as ASA score, pre-operative hemoglobin level and male gender. An elective laparoscopic approach should be used whenever possible.
目的:探讨非肿瘤性疾病行肾切除术患者术前哪些特征可预测术中并发症(IOC)和术后并发症(POC)。材料与方法:回顾性分析2002年至2019年在单一参考机构行单纯肾切除术的295例成人患者的人口统计学、术前特征、手术技术和围手术期结局。通过单因素和多因素统计分析,确定影响POC (Clavien-Dindo评分≥1)和IOC的因素。所有统计分析均使用statistical Package for the Social Sciences v. 24.0 (SPSS Inc., Chicago, IL, USA) Windows软件进行。结果:患者平均年龄44.84±15.51岁,男女比例为154/141。在多变量分析中,与IOC相关的有统计学意义的因素是男性、较高的美国麻醉学会(ASA)评分和紧急手术干预(p=0.002, p=0.001, p=0.021)。在多变量分析中,术前贫血、急诊手术和开放手术与POC有统计学意义(p<0.001, p=0.004, p=0.049)。结论:针对ASA评分、术前血红蛋白水平、男性性别等个体术前特征进行治疗,可改善手术效果。只要可能,应选择腹腔镜入路。