Analysis Of Factors Associated With Operative Time And Complications Of Posterior Laparoscopic Adrenal Tumor Resection

Purpose To investigate risk factors associated with the operative time and complications of posterior laparoscopic adrenal tumor resection.Method Case data of 233 patients undergoing posterior laparoscopic adrenal tumor resection from September 2015 to September 2021 at China-Japan Union Hospital of Jilin University were retrospectively analyzed,including age,BMI,underlying disease,history of abdominal surgery,tumor laterality,tumor size,operation time,perioperative complications and postoperative pathological data.All patients met the indications for surgery,received individualized perioperative management,and completed multidisciplinary consultations with relevant specialties,including surgeons,endocrinologists and anesthesiologists,prior to surgery.Complications were scored using the Dindo-Clavien classification system,and operative time was calculated from the start of skin incision to the end of suturing.Univariate and multifactorial regression analyses were performed using SPSS23.0 for factors related to operative time and the occurrence of perioperative complications.Result The results of the SPSS 23.0 regression analysis showed that.（1）In the univariate analysis of perioperative complications and operative time.（1）In perioperative complications: I the incidence of complications was 71.4% significantly higher in patients with a malignant pathology type than in those with a benign pathology type of 11.5%（P=0.000）;II the incidence of complications was 53.6% significantly higher in patients with a tumour diameter ≥6cm than in those with a tumour diameter <6cm at 7.8%（P=0.000）.The difference was statistically significant（P<0.05）.In summary,pathological type（malignant）（P=0.000）,and tumour diameter ≥6cm（P=0.000）were influential factors for perioperative complications.The difference was statistically significant（P<0.001）.II Patients with malignant pathology,85.7% had an operating time of more than 70 min compared to 55.3% of patients with benign pathology（P=0.226）.（P=0.226）,but the difference was not statistically significant（P>0.05）.In summary: tumour diameter ≥6cm was an influencing factor for longer operative time.（2）Multi-factor analysis in relation to operative time and complications.（1）Tumour diameter and pathological type were included in the multifactorial regression analysis in the univariate analysis of factors associated with perioperative complications.Tumour diameter ≥6cm（p=0.000）was an independent risk factor for the occurrence of perioperative complications.The rate of perioperative complications was higher in this group of patients with a tumour diameter ≥6cm,with a statistically significant difference（P<0.001）.（2）The pathological type and tumour diameter in the univariate analysis of factors related to the influence of operative time were included in the multifactorial regression analysis.A diameter of ≥6cm（P=0.006）was an independent factor for a longer operative time.The difference was statistically significant（P<0.01）in terms of longer operative time for this group of patients with tumour diameter ≥6cm.Conclusion Tumour diameter ≥6cm is an independent risk factor for perioperative complications and longer operative time.