Influencing factors on postoperative hospital stay after laparoscopic cholecystectomy

BACKGROUNDS/AIMS: Laparoscopic cholecystectomy can reduce postoperative pain and recovery time. However, some patients experience prolonged postoperative hospital stay. We aimed to identify factors influencing the postoperative hospital stay after laparoscopic cholecystectomy. METHODS: Patients (n=336) undergoing laparoscopic cholecystectomy for gallbladder pathology at 8 hospitals were enrolled and divided into 2 groups: 2 or less and more than 2 days postoperative stay. Perioperative factors and patient factors were retrospectively analyzed. RESULTS: The patient population median age was 52 years, and consisted of 32 emergency and 304 elective operations. A univariate analysis of perioperative factors revealed significant differences in operation time (p<0.001), perioperative transfusion (p=0.006), emergency operation (p<0.001), acute inflammation (p<0.001), and surgical site infection (p=0.041). A univariate analysis of patient factors revealed significant differences in age (p<0.001), gender (p=0.036), diabetes mellitus (p=0.011), preoperative albumin level (p=0.024), smoking (p=0.010), and American Society of Anesthesiologists score (p=0.003). In a multivariate analysis, operation time (p<0.001), emergency operation (p<0.001), age (p=0.014), and smoking (p=0.022) were identified as independent factors influencing length of postoperative hospital stay. CONCLUSIONS: Operation time, emergency operation, patient age, and smoking influenced the postoperative hospital stay and should be the focus of efforts to reduce hospital stay after laparoscopic cholecystectomy.

Analysis of Clinicopathologic Features of Papillary Thyroid Microcarcinoma According to Cut-off of Tumor Size / 대한내분비외과학회지

PURPOSE: Although the detected incidence of papillary thyroid microcarcinoma (PTMC) has increased with development of ultrasonography and fine-needle aspiration biopsy, the best treatment has not yet been established. Treatment decisions require information on many factors including lymph node metastasis, extrathyroidal extension, and bilaterality. With this aim, the present study analyzed clinicopathologic features of PTMC according to cut-off of tumor size. METHODS: The clinicopathologic features of patients with PTMC between January 2007 and December 2009 were reviewed retrospectively from medical records. Patients were divided according to tumors lesser than or equal to cut-off (Group I) and tumors exceeding cut-off (Group II). RESULTS: Both capsule invasion and lymphovascular invasion were significantly different at all cut-off diameters (5~9 mm). Central node metastasis revealed a difference in all cut-off values except 8 mm. Extrathyroidal extension differed at all cut-off values except 5 mm. Bilaterality displayed a statistically significantdifference only at the 8 mm cut-off. CONCLUSION: cut-off of 5 mm represents a safe value to discriminate less aggressive from aggressive treatment for PTMC.