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Revista argentina de cirugía

versão On-line ISSN 2250-639X

Resumo

VACCARO, Carlos A et al. El área de superficie corporal: un factor predictor de conversión en cirugía colorrectal laparoscópica. Rev. argent. cir. [online]. 2012, vol.103, n.4-6, pp.62-70. ISSN 2250-639X .

Background: Body surface área is a measurement used in clinical settings. Its impact on laparoscopic colorectal surgery has not been previously studied. Objective:To assess the impact of body surface área on conversión rate. Design: Retrospective analysis of prospectively collected data. Setting: Single tertiary care institution. Patients: 916 consecutive patients operated on between January 2004 and August 2011 were identified from a prospectively datábase. Main outcome measures: Conversión rate was analyzed related to age, gender, obesity, disease location (colon vs. rectum), type of disease (neoplastic vs. non-neoplastic), history of previous surgery, and body surface área; body surface área was calculated by Mosteller formula. Body surface área was analyzed using median and quartiles cut off valúes (1.6, 1.8 and 2.0). Logistic regression was used to analyze the association between body surface área and conversión, adjusting for different confounders. Interaction between body surface área and body mass Índex was checked and not found. Results: Overall conversión rate was 10%. Median body surface área was 1.84 (range: 1.14-2.53).Conversión rates for quartiles 1, 2, 3 and 4 were: 4.4%, 8.3%, 12.7%, and 14.8%, respectively, p = 0.001. Patients with body surface área > 1.8 (N=503) had a higher conversión rate than those with body surface área < 1.8 (N=413) [13.8% vs 6.3%, respectively, OR: 2.35 (95% Cl: 1.45-3.86; p=0.0001)j. Multivariate analysis showed that body surface área > 1.8 was associated with conversión (OR: 2, 95% Cl: 1.1-3.7, p=0.023) after adjusting for gender, age, and previous surgery. ROC analysis of body surface área showed an área under the curve of 0.62. Body surface área > 1.8 had a sensitivity and specificity of 76% and 48% respectively. Limitation: This was a single institution retrospective study. Conclusión: Body surface área is a good predictor for conversión and should be included as part of future studies on outcomes for laparoscopic colorectal surgery.

Palavras-chave : Laparoscopic colorectal surgery; Body mass Índex; Results.

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