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  1. 医学部
  1. 医学部
  2. 学術雑誌掲載論文  (医学部)

Identification of Risk Factors for Postoperative Hypotension Following Transurethral Bladder Tumor Resection Performed With Oral 5-Aminolevulinic Acid: A Multivariate Analysis of a Single-Center Retrospective Cohort Study

http://hdl.handle.net/10458/0002001890
http://hdl.handle.net/10458/0002001890
a58b5a89-789d-4f3c-b74b-0d1aed7f7d69
名前 / ファイル ライセンス アクション
20250512-420882-ma3ego.pdf 20250512-420882-ma3ego.pdf (580 KB)
アイテムタイプ 学術雑誌論文 / Journal Article(1)
公開日 2025-10-28
タイトル
タイトル Identification of Risk Factors for Postoperative Hypotension Following Transurethral Bladder Tumor Resection Performed With Oral 5-Aminolevulinic Acid: A Multivariate Analysis of a Single-Center Retrospective Cohort Study
言語 en
言語
言語 eng
キーワード
言語 en
キーワード 5-aminolevulinic acid
キーワード
言語 en
キーワード bladder tumor
キーワード
言語 en
キーワード multivariate analysis
キーワード
言語 en
キーワード postoperative hypotension
キーワード
言語 en
キーワード spinal anesthesia
キーワード
言語 en
キーワード transurethral resection
資源タイプ
資源タイプ journal article
アクセス権
アクセス権 open access
著者 押川, 隆

× 押川, 隆

WEKO 35067
e-Rad_Researcher 31010077

ja 押川, 隆
宮崎大学

ja-Kana オシカワ, タカシ

en Oshikawa, Takashi
University of Miyazaki

Search repository
丸田, 豊明

× 丸田, 豊明

WEKO 34465
e-Rad_Researcher 20363591

ja 丸田, 豊明
宮崎大学

ja-Kana マルタ, トヨアキ

en Maruta, Toyoaki
University of Miyazaki

Search repository
太田尾, 剛

× 太田尾, 剛

WEKO 34416
e-Rad_Researcher 40719506

ja 太田尾, 剛
宮崎大学

ja-Kana オオタオ, ゴウ

en Otao, Go
University of Miyazaki

Search repository
恒吉, 勇男

× 恒吉, 勇男

WEKO 8080
e-Rad_Researcher 90301390

ja 恒吉, 勇男
宮崎大学

ja-Kana ツネヨシ, イサオ

en Tsuneyoshi, Isao
University of Miyazaki

Search repository
抄録
内容記述タイプ Abstract
内容記述 Background
Transurethral resection of bladder tumors (TUR-Bt) using 5-aminolevulinic acid (5-ALA) is increasingly performed to visualize tumors. However, oral administration of 5-ALA frequently induces perioperative hypotension. Although several risk factors for intraoperative hypotension have been reported, those associated with postoperative hypotension have not yet been identified. We retrospectively evaluated risk factors for postoperative hypotension following TUR-Bt with 5-ALA administration.

Methods
The enrolled participants were patients who underwent TUR-Bt with 5-ALA under general or spinal anesthesia between July 2020 and December 2023. Patients who developed postoperative hypotension or used postoperative vasopressors were assigned to the hypotension group, and those who did not were assigned to the non-hypotension group. Postoperative mean blood pressure (mBP) was sampled from the electronic medical record at 1, 2, 3 and 6 hours after surgery. Postoperative hypotension was defined as an mBP of < 70 mmHg, noted at least once in the electronic medical records. Risk factors were identified using multivariate analysis. In addition, a subset of spinal anesthesia cases was similarly analyzed.

Results
Among 111 patients who underwent TUR-Bt with 5-ALA under general or spinal anesthesia, 46 and 65 were categorized into the hypotension and non-hypotension groups, respectively. Risk factors identified were estimated glomerular filtration rate (eGFR) ≤ 45-60 mL/min/1.73 m2, eGFR < 45 mL/min/1.73 m2, and mBP < 95 mmHg upon entering the operating room (odds ratio (OR) 3.026, 95% confidence interval (CI) 1.140-8.003, P = 0.027; OR 4.851, 95% CI 1.550-15.177, P = 0.007; and OR 2.443, 95% CI 1.018-5.865, P = 0.046, respectively). From the 111 patients, 88 underwent spinal anesthesia (38 hypotensive, 50 non-hypotensive). Risk factors identified among these patients were body mass index, eGFR ≤ 45-60 mL/min/1.73 m2, eGFR < 45 mL/min/1.73 m2, and mBP < 95 mmHg upon entering the operating room (OR 1.290, 95% CI 1.079-1.542, P = 0.006; OR 3.757, 95% CI 1.153-12.249, P = 0.029; OR 7.295, 95% CI 01.804-29.501, P = 0.006; and OR 3.134, 95% CI 1.061-9.262, P = 0.039, respectively).

Conclusion
Regardless of anesthesia method, impaired renal function increased postoperative hypotension, whereas higher blood pressure before anesthesia was less likely to result in postoperative hypotension.
言語 en
書誌情報 en : Cureus

巻 17, 号 4, p. e82112, 発行日 2025-04-11
出版者
出版者 Springer Science and Business Media LLC
言語 en
ISSN
収録物識別子タイプ PISSN
収録物識別子 21688184
DOI
関連タイプ isVersionOf
識別子タイプ DOI
関連識別子 https://doi.org/10.7759/cureus.82112
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出版タイプ VoR
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