New predictive factors for prolonged operation time of laparoscopic posterior retroperitoneal adrenalectomy; retrospective cohort study

Rah, Cheong-Sil; Kim, Won Woong; Lee, Yu‐Mi; Chung, Ki-Wook; Koh, Jung‐Min; Lee, Seung Hun; Hong, Suck Joon; Sung, Tae‐Yon

doi:10.1016/j.ijsu.2021.106113

Cited by 8 publications

(12 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some studies reported 4.2%–14.5% conversion rate for large adrenal lesions and 0.5%–5.6% for small adrenal lesions. [ 4 8 11 17 ] In our study, the conversion rate for the LT group and ST group was 6% and 0.9%, respectively. This is consistent with the literature.…”

Section: Discussionmentioning

confidence: 52%

See 1 more Smart Citation

Laparoscopic transperitoneal adrenalectomy for adrenal tumours of 6 cm or greater: A single-centre experience

Öz

Cucuk

Gök

et al. 2023

Journal of Minimal Access Surgery

View full text Add to dashboard Cite

Background: The present study aimed to evaluate the safety and efficacy of transperitoneal laparoscopic adrenalectomy (LA) for large adrenal tumours by comparing the outcomes of tumours larger than 6 cm with those smaller than 6 cm and also to identify the risk factors associated with prolonged operative time in transperitoneal LA. Patients and Methods: One hundred and sixty-three patients underwent LA at our clinic from January 2014 to December 2020. Bilateral LA was performed in 20 of these 163 patients. A total of 143 patients were included in this study. Data were analysed retrospectively from the patients’ medical records collected. Results: Large tumour (LT) group consists of 33 patients and the small tumour (ST) group consists of 110 patients. There was no statistically significant difference between the groups regarding conversion to open surgery and complications. A multiple regression analysis was conducted to identify the independent predictors of prolonged operation time. The tumour size ≥8 cm (odds ratio [OR], 19.132; 95% confidence interval [CI], 3.881–94.303; P < 0.001) and diagnosis of pheochromocytoma (OR, 2.762; 95% CI, (1.123–6.789, P = 0.026) were the significant predictors of prolonged operation time. Conclusion: Our study shows that LA can be considered the treatment of choice for small and large adrenal tumours. The tumour size ≥8 cm and diagnosis of pheochromocytoma are the independent risk factors for the prolonged operative time in transperitoneal LA.

show abstract

Section: Discussionmentioning

confidence: 52%

“…[ 7 8 9 ] Few studies have reported the risk factors for a prolonged operative time in transperitoneal LA for large adrenal tumours,[ 10 ] other in retroperitoneal LA. [ 11 12 ]…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic transperitoneal adrenalectomy for adrenal tumours of 6 cm or greater: A single-centre experience

Öz

Cucuk

Gök

et al. 2023

Journal of Minimal Access Surgery

View full text Add to dashboard Cite

show abstract

“…Fouche et al ( 36 ) found that an increase in body mass index (BMI) was associated with a longer duration of laparoscopic adrenal tumor surgery, while Manno et al ( 37 ) reported that obesity is positively correlated with visceral fat including periadrenal and perirenal fat. According to the literature, PF volume appears to be a better predictor of OT in RLAS than is BMI ( 11 , 38 ). Davidiuk et al created the MAP score, an image-based scoring system for kidney surgery, which is based on adherent PF ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…Tumor side: it has been demonstrated that RLAS via the posterior approach for right adrenal tumors requires a longer OT ( 11 ). Therefore, quantification was performed according to the location of the tumor (right or left side).…”

Section: Methodsmentioning

confidence: 99%

A computed tomography-based comprehensive standardized adrenal tumor scoring model for predicting the perioperative outcomes of retroperitoneal laparoscopic adrenal surgery

Xue,

Chen,

Yan

et al. 2024

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background Many imaging scoring models have been developed for tumor surgery to provide critical guidance for the selection of surgical methods. However, little research has been aimed at developing scoring models for adrenal tumors and retroperitoneal laparoscopic adrenal surgery (RLAS), which has become the primary technique for treating adrenal tumors. The study set out to establish a computed tomography (CT)-based adrenal tumor scoring model for predicting perioperative outcomes in patients with adrenal tumors who have undergone RLAS. Methods The retrospective analysis included 306 patients with adrenal tumors diagnosed by preoperative unenhanced or enhanced CT from January 2014 to August 2018 in the First Affiliated Hospital of Fujian Medical University. CT images were used to quantify the tumor location and size; the relationships of the tumors with the surrounding organs and tissues, the large abdominal blood vessels, and the upper poles of the kidneys and renal hila; the adhesion of periadrenal fat (PF); and the tumor CT enhancement value. We conducted multivariate ordinal logistic regression analysis to screen variables and performed principal component analysis to construct a novel scoring model for RLAS. The perioperative outcomes of RLAS were evaluated according to postoperative length of stay, operative time (OT), intraoperative blood loss (IBL), and postoperative complications. Results The final scoring model included tumor size; the relationships of the tumors with the surrounding organs and tissues, the large abdominal blood vessels, and the upper poles of the kidneys and renal hila; the tumor CT enhancement value; the adhesion of the PF; and the functional status of adrenal tumors. The total score had positive correlations with the OT (r s =0.431), IBL (r s =0.446), and postoperative length (r s =0.180) (all P values <0.001). Compared to any single metric, the total score provided better prediction of OT and IBL. The grading system for RLAS based on the scoring model also performed well in predicting the complexity and difficulty of RLAS. The coincidence rate for these factors was good (all P values <0.001). Conclusions The developed model is feasible and repeatable in the prediction of the perioperative outcomes, complexity, and difficulty of RLAS.

show abstract

“…The effect of sex on surgical difficulty might be explained by the difference in fat distribution between males and females at the same BMI ( 22 ). In addition, compared with females, males are more muscular, and have greater thickness and density of retroperitoneal fat, thus leading more difficult surgery ( 23 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

Establishment and validation of a nomogram for predicting the surgical difficulty of lateral retroperitoneal laparoscopic adrenalectomy

Zhao¹,

Wu²,

Qiu³

et al. 2023

Transl Androl Urol

View full text Add to dashboard Cite

Background: Lateral retroperitoneal laparoscopic adrenalectomy (LRLA) is widely performed for the resection of adrenal disorders, but when larger and more malignant lesions are involved, the difficulty of LRLA increases. We aimed to develop and evaluate a predictive model for the surgical difficulty of LRLA.Methods: A retrospective, observational, single-center study was performed involving all consecutive cases of unilateral RLA for adrenal disease from 2012.01 to 2021.12. Cases were randomly divided into training and validation cohorts (split ratio =7:3), then least absolute shrinkage and selection operator (LASSO) regression was applied to reduce data dimension and select predictors. Multivariate logistic regression followed to develop the prediction nomogram for the surgical difficulty of LRLA. Finally, receiver operating characteristic (ROC) curve, calibration curve plot and decision curve analysis (DCA) were used to evaluate the nomogram's discrimination, calibration, and clinical usefulness, respectively.Results: A total of 621 cases were enrolled with a median age of 53 years and a median tumor diameter of 1.7 cm. After LASSO regression analysis, surgeon's experience, tumor diameter, resection procedure, histological type, patient's sex and body mass index (BMI) were identified to establish the nomogram. The model displayed good discrimination with area under the curve (AUC) in both the training cohort (0.754, 95% CI: 0.701-0.806) and validation cohort (0.742, 95% CI: 0.646-0.838). Additionally, excellent calibration curves were revealed for surgical difficulty evaluation in both the training cohort (P=0.999) and validation cohort (P=0.444). DCA results indicated the prediction model was clinically useful.Conclusions: Our novel and effective predictive model can be used to assess the individual surgical difficulty of LRLA. By stratifying patients at risk of having a difficult LRLA for adrenal disease, the model could contribute to improvements in perioperative strategy and therapy.

show abstract

New predictive factors for prolonged operation time of laparoscopic posterior retroperitoneal adrenalectomy; retrospective cohort study

Cited by 8 publications

References 29 publications

Laparoscopic transperitoneal adrenalectomy for adrenal tumours of 6 cm or greater: A single-centre experience

Laparoscopic transperitoneal adrenalectomy for adrenal tumours of 6 cm or greater: A single-centre experience

A computed tomography-based comprehensive standardized adrenal tumor scoring model for predicting the perioperative outcomes of retroperitoneal laparoscopic adrenal surgery

Establishment and validation of a nomogram for predicting the surgical difficulty of lateral retroperitoneal laparoscopic adrenalectomy

Contact Info

Product

Resources

About