Descripción y evaluación estandarizada de complicaciones asociadas a adrenalectomía laparoscópica

Castillo, Octavio A.; Rodríguez-Carlin, A.; Lopez-Vallejo, JF; Borgna, Vincenzo

doi:10.1016/j.acuro.2013.12.007

Cited by 12 publications

(2 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most dangerous after-effects of hypertensive crisis are cardio-respiratory arrest and cerebral infarction. Early control of the adrenal vein and minimal tumor manipulation are essential for an uneventful procedure [ 11 , 14 – 16 ].…”

Section: Discussionmentioning

confidence: 99%

Perioperative complications of adrenalectomy – 12 years of experience from a single center/teaching hospital and literature review

Aporowicz

Domosławski

Czopnik

et al. 2018

aoms

View full text Add to dashboard Cite

IntroductionThe perioperative complication rate of adrenalectomy varies between 1.7% and 30.7% in the medical literature. This study presents outcomes of adrenalectomy in our center and tries to point out risk factors for perioperative problems.Material and methodsWe retrospectively analyzed all patients who underwent adrenalectomy in our department from January 2004 to June 2015. Patient’s sex, indication for procedure, tumor laterality, surgical approach and surgeon’s case volume were taken into consideration as possible risk factors for complications.ResultsThere were 177 adrenalectomies performed on 170 patients. We reported 18 (10.2%) perioperative complications, 12 (6.8%) surgical and 6 (3.4%) medical. Laparotomy was a significant risk factor for medical (p < 0.01) and overall problems (p = 0.02). Operations more expansive than just adrenalectomy were associated with higher risk of medical complications (p = 0.01). Procedures performed by surgeons with higher volume were associated with smaller risk of medical complications (p < 0.01). Right and left adrenalectomies seem to be related to different kinds of risk – bleeding on the right, injury of surrounding structures on the left (p = 0.05). Patient’s sex, indication for procedure, bilateral procedure and side of operation were not statistically significant risk factors for complications.ConclusionsAdrenal glands are surrounded by various anatomic structures (colon, pancreas, spleen, diaphragm) that may be injured during adrenalectomy. Complications following a laparoscopic procedure may arise from the use of monopolar coagulation and the patient’s position on the operating table. High insufflation pressure during retroperitoneoscopic procedures may cause subcutaneous emphysema.

show abstract

Section: Discussionmentioning

confidence: 99%

Perioperative complications of adrenalectomy – 12 years of experience from a single center/teaching hospital and literature review

Aporowicz

Domosławski

Czopnik

et al. 2018

aoms

View full text Add to dashboard Cite

show abstract

“…Many studies demonstrate that the size of the mass and the histopathological diagnosis of phaeochromocytoma were independent risks factors of the perioperative complications rate. LA in large adrenal masses (> 8 cm) is associated with prolonged operative time, increased blood loss, and longer hospitalisation, without affecting perioperative morbidity [65].…”

Section: What Parameter Can Be Used To Assess/define Expertise In Adrmentioning

confidence: 99%

Volume-outcome correlation in adrenal surgery—an ESES consensus statement

Mihai

Donatini

Vidal

et al. 2019

Langenbecks Arch Surg

View full text Add to dashboard Cite

Background Published data in the last decade showed that a majority of adrenal operations are done by surgeons performing only one such case per year and based on the distribution of personal workloads 'high-volume' surgeons are defined as those doing 4 or more cases/year. Purpose This paper summarises literature data identified by a working group established by the European Society of Endocrine Surgeons (ESES). The findings were discussed during ESES-2019 conference and members agreed on a consensus statement. Results The annual of adrenal operations performed yearly in individual countries was reported to be 800/year in UK and over 1600/year in France. The learning curve of an individual surgeon undertaking laparoscopic, retroperitoneoscopic or robotic adrenalectomy is estimated to be 20-40 cases. Preoperative morbidity and length of stay are more favourable in high-volume centres. Conclusion The main recommendations are that adrenal surgery should continue only in centres performing at least 6 cases per year, surgery for adrenocortical cancer should be restricted to centres performing at least 12 adrenal operations per year, and an integrated multidisciplinary team should be established in all such centres. Clinical information regarding adrenalectomies should be recorded prospectively and contribution to the established EUROCRINE and ENSAT databases is strongly encouraged. Surgeons wishing to develop expertise in this field should seek mentorship and further training from established adrenal surgeons.

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

Descripción y evaluación estandarizada de complicaciones asociadas a adrenalectomía laparoscópica

Cited by 12 publications

References 26 publications

Perioperative complications of adrenalectomy – 12 years of experience from a single center/teaching hospital and literature review

Perioperative complications of adrenalectomy – 12 years of experience from a single center/teaching hospital and literature review

Volume-outcome correlation in adrenal surgery—an ESES consensus statement

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

Contact Info

Product

Resources

About