Prevention of Conversion in Posterior Retroperitoneal Adrenalectomy by Measuring Preoperative Anatomical Conditions on Cross-sectional Imaging (CT or MRI)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 14
- 试验地点
- 1
- 主要终点
- Sagittal distance between the dorsal border of the adrenal gland and the 12th rib tip
研究概览
简要总结
With our retrospective study the investigators show the limitations of the posterior retroperitoneal adrenalectomy by analyzing anatomical parameters.
The investigators compared the data from one patient who underwent a conversion with 13 patients without a conversion. Furthermore, they explored the influence of these parameters on the operation time and excluded the patient who had a conversion from this analysis.
The investigators hypothesize that by determining anatomical characteristics on cross-sectional imaging (CT or MRI), they can show the limitations of the posterior retroperitoneal adrenalectomy to prevent patients from being converted to lateral transperitoneal adrenalectomy.
详细描述
Minimally invasive adrenalectomy has become the gold standard for the surgical treatment of small, benign adrenal lesions. In addition to the common laparoscopic lateral transperitoneal adrenalectomy, the posterior retroperitoneal adrenalectomy is becoming increasingly important.
To date, there is no consensus regarding the preferred approach in the resection of benign adrenal tumors. A comprehensive adrenal tumor program should be able to offer both options, however, patient selection criteria for a given approach have not yet been defined. The choice between lateral transperitoneal adrenalectomy and posterior retroperitoneal adrenalectomy is relevant for patients with unilateral tumors < 6-7 cm and without previous abdominal surgery.
The aim of this study was to determine the limits of posterior retroperitoneal adrenalectomy using anatomical parameters to enable the preferred access to be chosen preoperatively to prevent conversion. In addition, the investigators describe the relationship between these parameters and the operation time to find a measure of the degree of technical difficulty.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients whose adrenal gland was removed with retroperitoneal access
- •Operation was between 01.07.2016 and 31.12.2018
- •Operation was at the Kantonsspital Aarau
排除标准
- •Patients with multivisceral resection
结局指标
主要结局
Sagittal distance between the dorsal border of the adrenal gland and the 12th rib tip
时间窗: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
Measurement of preoperative anatomical conditions on cross- sectional imaging (CT or MRI). Sagittal distance between the dorsal border of the adrenal gland and the 12th rib tip, mm.
Thickness of retroperitoneal fat
时间窗: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
Measurement of preoperative anatomical conditions on cross- sectional imaging (CT or MRI). Defined as the largest distance between the kidney parenchyma and the posterior abdominal wall at the level where the renal vein joins the vena cava inferior.
Sagittal thickness of the subcutaneous layer above the 12th rib tip
时间窗: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
Measurement of preoperative anatomical conditions on cross- sectional imaging (CT or MRI). Sagittal thickness of the subcutaneous layer above the 12th rib tip, mm.
Posterior Adiposity Index
时间窗: The measurement of the parameter from the cross-sectional image was performed in the period from 19.11.2018 - 04.02.2019.
Measurement of preoperative anatomical conditions on cross- sectional imaging (CT or MRI). Distance from skin to renal parenchyma through the 12th rib tip. The larger the distance, the larger the index. The scale ranges are open.
Longitudinal distance between the 12th rib and the iliac crest
时间窗: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
Measurement of preoperative anatomical conditions on cross- sectional imaging (CT or MRI). Longitudinal distance between the 12th rib and the iliac crest, mm.
Sagittal thickness of the subcutaneous layer between the center of gravity and the lateral border of the body
时间窗: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
Measurement of preoperative anatomical conditions on cross- sectional imaging (CT or MRI). Sagittal thickness of the subcutaneous layer between the center of gravity and the lateral border of the body, measured at the level of the 12th rib tip, mm.
Longitudinal distance between the superior border of the adrenal gland to the 12th rib tip.
时间窗: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
Measurement of preoperative anatomical conditions on cross- sectional imaging (CT or MRI). Longitudinal distance between the superior border of the adrenal gland to the 12th rib tip, mm.
Sagittal thickness of the subcutaneous layer above the iliac crest
时间窗: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
Measurement of preoperative anatomical conditions on cross- sectional imaging (CT or MRI). Sagittal thickness of the subcutaneous layer above the iliac crest, mm.
Thickness of the subcutaneous layer above the 12th rib tip
时间窗: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
Measurement of preoperative anatomical conditions on cross- sectional imaging (CT or MRI). Thickness of the subcutaneous layer above the 12th rib tip, measured on the straight line to the center of gravity, mm.
Longitudinal distance between the upper pole of the kidney and the inferior border of the adrenal gland.
时间窗: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
Measurement of preoperative anatomical conditions on cross- sectional imaging (CT or MRI). Longitudinal distance between the upper pole of the kidney and the inferior border of the adrenal gland, mm.
Tumor size
时间窗: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
Measurement of preoperative anatomical conditions on cross- sectional imaging (CT or MRI). Tumor size, cm.
Operative time
时间窗: The data were collected between 19.11.2018 and 04.02.2019.
Duration of adrenalectomy. Data were extracted and analyzed from the hospital information system.
次要结局
- Age(The data were collected between 19.11.2018 and 04.02.2019.)
- Previously performed abdominal surgeries taken from the hospital information system(The data were collected between 19.11.2018 and 04.02.2019.)
- Body-Mass-Index(The data were collected between 19.11.2018 and 04.02.2019.)
- Sex(The data were collected between 19.11.2018 and 04.02.2019.)
- Histological diagnosis of the sample from the adrenalectomy(The data were collected between 19.11.2018 and 04.02.2019.)
- The side of the adrenal gland that was removed(The data were collected between 19.11.2018 and 04.02.2019.)
- Imaging(The data were collected between 19.11.2018 and 04.02.2019.)
研究者
Simone Eichelberger
BMed
University of Basel