Adrenal Surgery in Spain: Final Results of a National Survey

Moral, Jesús María Villar del; González, José Manuel Rodríguez; Llorente, Pablo Moreno; Martínez, Juan Manuel Martos; Barrasate, Aitor de la Quintana; Rodríguez, Amaia Expósito; Lesquereux, Lucía Martínez; Póveda, Manuel Durán

doi:10.1016/j.cireng.2011.07.002

Cited by 7 publications

(6 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At present, intra or post-operative complications after laparoscopic adrenalectomy are rare, especially uncomplicated cases (24). Studies have shown complication rates of laparoscopic adrenalectomy ranging from 6.5% to 15% (5,15,(25)(26)(27)(28). In our retrospective study, total complications were 12% (18/150), mainly Clavien-Dindo grade 1 minor complications, of which 19.67% (12/61) and 6.74% (6/89) in the group with and without drains, respectively.…”

Section: Discussionmentioning

confidence: 99%

Should surgical drainage after lateral transperitoneal laparoscopic adrenalectomy be routine?—A retrospective comparative study

Chai¹,

Pan²,

Liang³

et al. 2021

Gland Surg

View full text Add to dashboard Cite

Background: Whether to use surgical drains after abdominal surgery or not has received much attention since a hundred years ago. Nowadays, lateral transperitoneal laparoscopic adrenalectomy (LTLA) is a widely used technique to treat adrenal tumors worldwide. However, the placement of drains after LTLA remains controversial. Methods: Data of 150 patients, who underwent LTLA between October 2014 and September 2020 by the same lead surgeon, were collected, including demographic, pathology, preoperative, operative variables and postoperative complications. The patients were divided into two groups, with and without drainage. The postoperative recovery of the two groups was compared. Results: Among 150 patients (65 men and 85 women, median age 48 years, median BMI 23.53), 89 patients had no drainage and 61 patients had drainage after surgery. Variables of the two groups were analyzed. Placement of drains correlated with long operative time (P<0.01). Patients with drain had longer hospital stays (P<0.001) and a higher incidence of postoperative complications (P=0.022). Other factors, including tumor size (P=0.61), tumor location (P=0.387), ASA score (P=0.687), pathology (P=0.55), VAS pain score (P=0.41), intraoperative blood loss (P=0.11), were not found to be significantly associated with drain placement. There was no conversion to open surgery in both groups. Moreover, no mortality was observed in either group.Conclusions: this study revealed that it is feasible and safe not to leave a drain in selective and uncomplicated patients and that surgical drainage should not be routine after LTLA.

show abstract

Section: Discussionmentioning

confidence: 99%

Should surgical drainage after lateral transperitoneal laparoscopic adrenalectomy be routine?—A retrospective comparative study

Chai¹,

Pan²,

Liang³

et al. 2021

Gland Surg

View full text Add to dashboard Cite

show abstract

“…In a survey conducted by the endocrine surgery section of Spanish Association of Surgeons, 11 it was found that the LA was generally the procedure chosen by 84% of the surgeons who responded to the survey. According to their results, they had a lower rate for conversion to laparotomy (6.7%), overall morbidity (8.9%), urgent re-operation (2.3%) and mortality (0.3%) as well as a length of hospital stay of 4.9 days.…”

Section: Surgical Management and Factors Relatedmentioning

confidence: 99%

“…16 Once the approach is chosen, which in most of the cases will be laparoscopically, adrenalectomies can be performed safely. 11…”

Section: Surgical Management and Factors Relatedmentioning

confidence: 99%

“…Each adrenalectomy performed on each side has specific anatomical landmarks that skilled endocrine surgeon has to respect in order to perform a standard adrenalectomy. 11…”

Section: La To the Adrenal Glandmentioning

confidence: 99%

“…21,23–26 Thus, a lower rate of postoperative complications and hospital stay after adrenalectomy is found when it is performed by a surgeon and in a hospital with a high volume of surgical activity. 11 Laparoscopic adrenalectomy is currently used to treat patients for whom malignancy is not suspected, while open surgery is still considered the standard treatment approach in patients with suspect of malignancy. 27…”

Section: Factors Related To Laparoscopic Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

Past and present in abdominal surgery management for Cushing’s syndrome

et al. 2014

View full text Add to dashboard Cite

Introduction:Data on specific abdominal surgery and Cushing’s syndrome are infrequent and are usually included in the adrenalectomy reports. Current literature suggests the feasibility and reproducibility of the surgical adrenalectomies for patients diagnosed with non-functioning tumours and functioning adrenal tumours including pheochromocytoma, Conn’s syndrome and Cushing’s syndrome.Discussion:Medical treatment for Cushing’s syndrome is feasible but follow-up or clinical situations force the patient to undergo a surgical procedure. Laparoscopic surgery has become a gold standard nowadays in a broad spectrum of pathologies. Laparoscopic adrenalectomies are also standard procedures nowadays. However, despite the different characteristics and clinical disorders related to the laparoscopically removed adrenal tumours, the intraoperative and postoperative outcomes do not significantly differ in most cases between the different groups of patients, techniques and types of tumours. Tumour size, hormonal type and surgeon’s experience could be different factors that predict intraoperative and postoperative complications. Transabdominal and retroperitoneal approaches can be considered. Outcomes for Cushing’s syndrome do not differ depending on the surgical approach. Novel technologies and approaches such as single-port surgery or robotic surgery have proven to be safe and feasible.Conclusion:Laparoscopic adrenalectomy is a safe and feasible approach to adrenal pathology, providing the patients with all the benefits of minimally invasive surgery. Single-port access and robotic surgery can be performed but more data are required to identify their correct role between the different surgical approaches. Factors such as surgeon’s experience, tumour size and optimal technique can affect the outcomes of this surgery.

show abstract

Risk factors for complications after adrenalectomy: results from a comprehensive national database

Thompson

Nordenström

Almquist

et al. 2016

Langenbecks Arch Surg

View full text Add to dashboard Cite

PurposeMost knowledge regarding outcome after adrenal surgery stems from retrospective studies reported by highly specialized centres. The aim of this study was to report a national experience of adrenalectomy with particular attention to predictive factors for postoperative complications, conversion from endoscopic to open surgery and length of hospital stay.MethodsAdrenalectomies reported in the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery (SQRTPA) 2009–2014 were included. Risk factors for complications, conversion and hospital stay >3 days were assessed using univariable and multivariable logistic regression analysis.ResultsThere were 659 operations. Endoscopic adrenalectomy was performed in 513 (77.8%) operations and almost half of these were robotic assisted. The median length of hospital stay was 3 (range 1–30) days. There was no 30-day mortality. In 43 (6.6%) patients, at least one complication was registered. The only factor associated with complications in multivariable analysis was conversion to open surgery odds ratio (OR) 3.61 (95% confidence interval 1.07 to 12.12). The risk for conversion was associated with tumour size OR 1.03 (1.00 to 1.06) and with malignancy on histopathology OR 8.33 (2.12 to 32.07). Length of hospital stay increased in patients with operation of bilateral tumours OR 3.13, left-sided tumours OR 1.98, hyper secretion of catecholamines OR 2.32, conversion to open surgery OR 42.05 and open surgery OR 115.18.ConclusionsThe present study shows that endoscopic surgery is widely used. Complications were associated with conversion and the risk for conversion was associated with tumour size and malignant tumour. Hospital stay was short.Electronic supplementary materialThe online version of this article (doi:10.1007/s00423-016-1535-8) contains supplementary material, which is available to authorized users.

show abstract

Adrenal Surgery in Spain: Final Results of a National Survey

Cited by 7 publications

References 18 publications

Should surgical drainage after lateral transperitoneal laparoscopic adrenalectomy be routine?—A retrospective comparative study

Should surgical drainage after lateral transperitoneal laparoscopic adrenalectomy be routine?—A retrospective comparative study

Past and present in abdominal surgery management for Cushing’s syndrome

Risk factors for complications after adrenalectomy: results from a comprehensive national database

Contact Info

Product

Resources

About