Male gender and increased body mass index independently predicts clinically relevant morbidity after spleen-preserving distal pancreatectomy  

作　　者：Traian Dumitrascu Mihai Eftimie ANDra Aiordachioae Cezar Stroescu Simona Dima Mihnea Ionescu Irinel Popescu 

机构地区：[1]Department of General Surgery and Liver Transplant, Fundeni Clinical Institute

出　　处：《World Journal of Gastrointestinal Surgery》2018年第8期84-89,共6页世界胃肠外科杂志（英文版）（电子版）

摘　　要：AIM To identify risk factors for clinically relevant complications after spleen-preserving distal pancreatectomy(SPDP). No previous studies explored potential predictors of morbidity after SPDP.METHODS The data of 41 patients who underwent a SPDP in a single surgical center between 2000 and 2015 were retrospectively reviewed from a prospectively maintained electronic database established in our Department of Surgery. The database included demographic, clinical, bioumoral, pathological, intraoperative and postoperative parameters. Uni-and multivariate ana-lyses were performed to assess potential predictors of clinically relevant morbidity. Postoperative morbidity was defined as in-hospital complications and mortality was assessed at 90 d. Clinically relevant morbidity was defined as complication ≥ grade 2 Dindo.RESULTS Overall morbidity rate was 34.1%(14 patients): grade Ⅰ(6 patients, 14.6%), grade Ⅱ(2 patients, 4.8%), grade Ⅲa(1 patient, 2.4%), and grade Ⅲb(5 patients, 12.2%). A number of 5 patients(12.2%) required re-laparotomy for postoperative complications. There was no postoperative mortality. Thus, at least one clinically relevant complication occurred in 8 patients(19.5%). Univariate analysis identified male gender(P = 0.034), increased body mass index(P = 0.002) and neuroendocrine pathology(P = 0.013) as statistically significant risk factors. Multivariate analysis identified male gender [odds ratio(OR): 1.29, 95%CI: 1.07-1.55, P = 0.005] and increased body mass index(OR: 23.18, 95%CI: 1.72-310.96, P = 0.018) as the only independent risk factors of clinically relevant morbidity after SPDP.CONCLUSION Male gender and increased body mass index are independently associated with increased risk of clinically relevant morbidity after SPDP. These findings may assist a surgeon in clinical decision-making to better select patients suitable for SPDP.AIMTo identify risk factors for clinically relevant compli-cations after spleen-preserving distal pancreatectomy （SPDP）. No previous studies explored potential pre-dictors of morbidity after SPDP.METHODSThe data of 41 patients who underwent a SPDP in a single surgical center between 2000 and 2015 were retrospectively reviewed from a prospectively maintained electronic database established in our Department of Surgery. The database included demographic, clinical, bioumoral, pathological, intraoperative and postoperative parameters. Uni- and multivariate analyses were performed to assess potential predictors of clinically relevant morbidity. Postoperative morbidity was defined as in-hospital complications and mortality was assessed at 90 d. Clinically relevant morbidity was defined as complication ≥ grade 2 Dindo.RESULTSOverall morbidity rate was 34.1% （14 patients）： grade Ⅰ （6 patients, 14.6%）, grade Ⅱ （2 patients, 4.8%）, grade Ⅲa （1 patient, 2.4%）, and grade Ⅲb （5 patients, 12.2%）. A number of 5 patients （12.2%） required re-laparotomy for postoperative complications. There was no postoperative mortality. Thus, at least one clinically relevant complication occurred in 8 patients （19.5%）. Univariate analysis identified male gender （P = 0.034）, increased body mass index （ P = 0.002） and neuroendocrine pathology （P = 0.013） as statistically significant risk factors. Multivariate analysis identified male gender [odds ratio （OR）： 1.29, 95%CI： 1.07-1.55, P = 0.005] and increased body mass index （OR： 23.18, 95%CI： 1.72-310.96, P = 0.018） as the only independent risk factors of clinically relevant morbidity after SPDP.CONCLUSIONMale gender and increased body mass index are in-dependently associated with increased risk of clinically relevant morbidity after SPDP. These findings may assist a surgeon in clinical decision-making to better select patients suitable for SPDP.

关 键 词：Spleen-preserving distal pancreatectomy MORBIDITY Male gender Body mass index 

分 类 号：R657.6[医药卫生—外科学] R657.5[医药卫生—临床医学]