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. 2017 Mar;402(2):315-322.
doi: 10.1007/s00423-016-1535-8. Epub 2016 Nov 28.

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

Lo Hallin Thompson  1 , Erik Nordenström  2 , Martin Almquist  2 , Helene Jacobsson  3 , Anders Bergenfelz  2
Affiliations

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

Lo Hallin Thompson et al. Langenbecks Arch Surg. 2017 Mar.

Abstract

Purpose: Most 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.

Methods: Adrenalectomies 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.

Results: There 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.

Conclusions: The 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.

Keywords: Adrenalectomy; Complications; Conversion; Laparoscopic.

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Conflict of interest statement

Funding

This study was funded by Skåne Regional Research and Development Fund, Skåne University Hospital Foundation, Skåne University Hospital and Lund University.

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

Quality control and analysis of complications were performed according to Swedish legislations for health care providers, and ethical approval was therefore accordingly void.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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