Preoperative Risk Factors Analysis For Hemodynamic Stability In Retroperitoneal Laparoscopic Pheochromocytoma Resection

Objective:To Analysis preoperative risk factors for hemodynamic stability in retroperitoneal laparoscopic pheochromocytoma resection,provide a basis for the surgical risk assessment of patients,and further improve the safety of patients’surgery.Methods:In this study,From January 2015 to December 2019,92 patients with pheochromocytoma was treated by retroperitoneal laparoscopic surgery in the urology department of the first hospital of Shanxi Medical University.HI was defined as the presence of at least once instance of intraoperative systolic blood pressure>200 mmHg or a mean arterial pressure<60 mmHg,or the requirement for norepinephrine,which was divided into30 cases of hemodynamic instability group and 62 cases of hemodynamic stability group.The demographic characteristics(gender,age,body mass index),clinical symptoms,preoperative examination and examination,and perioperative hemodynamics were recorded.Spss21.0 statistical software is used to process the data;the measurement data of normal distribution is represented by?x±s,and the comparison is represented by t test;the measurement data of non normal distribution is represented by median(interquartile spacing),and the comparison is represented by Mann Whitney U test;the count data is represented by case and the comparison is represented byχ~2 test.Then,the single preoperative variable with P<0.1 was selected to be included in the multivariate statistical analysis,and the multivariate statistical regression was used in the multivariate analysis.α=0.05.Results:Univariate analysis:there were 18 cases in HI group and 22 cases in HD group,the difference was statistically significant(χ~2=4.318,P=0.046).CT showed that the tumor diameter was 5.21±2.61cm,in which 30 cases(32%)were larger than 6cm(χ~2=8.701,P=0.005).There were statistically significant differences during surgery in the maximum SBP(t=4.25,P<0.001),the maximum SBP(t=-7.50,P<0.001),the minimum DBP(t=.7.67,P<0.001),and the amount of bleeding(t=2.52,P=0.013).The results showed that CT tumor diameter>6cm,preoperative blood glucose rise were independent risk factors for hemodynamic instability during retroperitoneal laparoscopic pheochromocytoma surgery(OR=2.933,95%CI=1.033-4.546,P=0.029;OR=3.918,95%CI=1.552-8.079,P=0.003)).Conclusion:This study shows that the size of pheochromocytoma tumor diameter and abnormal blood glucose are independent predictors of hemodynamic stability in retroperitoneal laparoscopic pheochromocytoma resection,which are helpful to assess the risk of surgery,identify the high-risk patients and carry out more detailed preoperative preparation for the safety of surgery.