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. 2023 Oct;37(10):7573-7581.
doi: 10.1007/s00464-023-10148-0. Epub 2023 Jul 13.

Risk factors for intraoperative complications, postoperative complications, and prolonged length of stay after laparoscopic adrenalectomy by transperitoneal lateral approach: a retrospective cohort study of 547 procedures

Donatien Fouche  1 , Gabrielle Chenais  2 , Magalie Haissaguerre  3 , Damien Bouriez  1 , Caroline Gronnier  1 , Denis Collet  1 , Antoine Tabarin  3 , Haythem Najah  4   5
Affiliations

Risk factors for intraoperative complications, postoperative complications, and prolonged length of stay after laparoscopic adrenalectomy by transperitoneal lateral approach: a retrospective cohort study of 547 procedures

Donatien Fouche et al. Surg Endosc. 2023 Oct.

Abstract

Background: Laparoscopic adrenalectomy (LA) is the gold standard for the resection of most adrenal lesions. A precise delineation of factors influencing its outcomes is lacking. The aim of this study was to assess factors associated with intraoperative complications, postoperative complications, and prolonged length of stay (LOS) after LA.

Methods: Patients who underwent LA from 1999 to 2021 in a single-academic-institution were included. Patient and disease-specific data, intraoperative complications, postoperative complications according to Dindo-Clavien (DC) scale, and LOS were recorded. Predictive factors of complications and prolonged LOS were determined by logistic regression.

Results: We identified 530 patients who underwent 547 LA. Intraoperative complications occurred in 33 patients (6.0%). Postoperative complications ≥ DC grade 2 occurred in 73 patients (13.35%); severe postoperative complications ≥ DC grade 3 in 14 patients (2.56%). Postoperative complications were positively associated with age ≥ 72 (OR 1.14 [95% CI 1.02-1.29]), intraoperative complications (OR 1.36 [95% CI 1.14-1.63]), and negatively associated with non functional adenomas (OR 0.88 [95% CI 0.7-0.99]), and right adrenalectomy (OR 0.91 [95% CI 0.86-0.97]). Severe postoperative complications were positively associated with chronic obstructive pulmonary disease (COPD, OR 1.08 [95% CI 1.00-1.17]), and negatively associated with right adrenalectomy (OR 0.97 [95% CI 0.92-0.99]). Prolonged LOS was associated with age ≥ 72 (OR 1.21 [95% CI 1.05-1.41]), and COPD (OR 1.20 [95% CI 1.01-1.44]).

Conclusions: LA remains safe when performed by surgeons with expertise. Right adrenalectomy resulted in less postoperative overall and severe complications. The risk-benefit equation should be carefully assessed before left LA in older patients with COPD.

Keywords: Adrenalectomy; Complication; Laparoscopy; Transperitoneal.

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References

    1. Gagner M et al (1992) Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma. N Engl J Med 327:1033–1033. https://doi.org/10.1056/NEJM199210013271417 - DOI - PubMed
    1. Eichhorn-Wharry LI, Talpos GB, Rubinfeld I (2012) Laparoscopic versus open adrenalectomy: another look at outcome using the Clavien classification system. Surgery 152:1090–1095. https://doi.org/10.1016/j.surg.2012.08.020 - DOI - PubMed
    1. Lee J, El-Tamer M, Schifftner T, Turrentine FE, Henderson WG, Khuri S, Hanks JB, Inabnet WB (2008) Open and laparoscopic adrenalectomy: analysis of the National Surgical Quality Improvement Program. J Am Coll Surg 206:953–959. https://doi.org/10.1016/j.jamcollsurg.2008.01.018 - DOI - PubMed
    1. Conzo G, Tartaglia E, Gambardella C, Esposito D, Sciascia V, Mauriello C, Nunziata A, Siciliano G, Izzo G, Cavallo F, Thomas G, Musella M, Santini L (2016) Minimally invasive approach for adrenal lesions: systematic review of laparoscopic versus retroperitoneoscopic adrenalectomy and assessment of risk factors for complications. Int J Surg 28:S118–S123. https://doi.org/10.1016/j.ijsu.2015.12.042 - DOI - PubMed
    1. Perivoliotis K, Baloyiannis I, Sarakatsianou C, Tzovaras G (2020) Comparing the efficacy and safety of laparoscopic and robotic adrenalectomy: a meta-analysis and trial sequential analysis. Langenbecks Arch Surg 405:125–135. https://doi.org/10.1007/s00423-020-01860-9 - DOI - PubMed

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