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The applicability of laparoscopic adrenalectomy and our experience at a secondary health institution


Üsküdar University, School of Medicine, Memorial Bahçelievler Hospital, Department of Urology, İstanbul, Turkey


DOI : 10.33719/yud.2023;18-1-1222172
New J Urol. 2023;18(1):78-84
ABSTRACT

ABSTRACT

Objective: Since the laparoscopy education had became widespread, the advance laparoscopic procedures can be performed even at secondary public hospitals. In this study, we aimed to present our experience of the first seven years of laparoscopic transperitoneal adrenalectomy.
Material And Methods: the study included 30 patients with laparoscopic transperitoneal adrenalectomy (LA) performed from October 2012 to April 2019. The retrospective assessment investigated age, sex, body mass index, adrenal mass characteristics, hormonal activity, operation duration, hemorrhage status, transfusion requirements, final pathology and complication rates.
Results: Mean age was 54.3±11.5 years and mean body mass index was 25.6±2.7 kg/m2. Mean mass size was 48.5±23 mm and mean operation duration was 70.2±21.6 minutes. Mean peroperative hemorrhage amount was 41±48.8 cc, while only 2 patients required transfusion. Mean hospitalization duration was 1.3±0.88 days. None of the laparoscopic cases was converted to open surgery, and no major complications such as death recorded.
Conclusion: Transperitoneal laparoscopic adrenalectomy (LA) surgery may be performed safely after adequate training for appropriate patients with low morbidity and mortality.

Keywords: Laparoscopy, Adrenalectomy, Experience, Open surgery, Transperitoneal

ABSTRACT

Objective: Since the laparoscopy education had became widespread, the advance laparoscopic procedures can be performed even at secondary public hospitals. In this study, we aimed to present our experience of the first seven years of laparoscopic transperitoneal adrenalectomy.
Material And Methods: the study included 30 patients with laparoscopic transperitoneal adrenalectomy (LA) performed from October 2012 to April 2019. The retrospective assessment investigated age, sex, body mass index, adrenal mass characteristics, hormonal activity, operation duration, hemorrhage status, transfusion requirements, final pathology and complication rates.
Results: Mean age was 54.3±11.5 years and mean body mass index was 25.6±2.7 kg/m2. Mean mass size was 48.5±23 mm and mean operation duration was 70.2±21.6 minutes. Mean peroperative hemorrhage amount was 41±48.8 cc, while only 2 patients required transfusion. Mean hospitalization duration was 1.3±0.88 days. None of the laparoscopic cases was converted to open surgery, and no major complications such as death recorded.
Conclusion: Transperitoneal laparoscopic adrenalectomy (LA) surgery may be performed safely after adequate training for appropriate patients with low morbidity and mortality.

Keywords: Laparoscopy, Adrenalectomy, Experience, Open surgery, Transperitoneal

Resources

  • 1.Sung TY, Tennakoon L, Alobuia WM, Seib C, Cisco R, Lin D, Kebebew E. Factors associated with postoperative complications and costs for adrenalectomy in benign adrenal disorders. Surgery. 2022;171:1519–525. https://doi.org/10.1016/j.surg.2021.10.065
    CROSSREF
  • 2.Lee J, El-Tamer M, Schifftner T, et al. Open and laparoscopic adrenalectomy: analysis of the National Surgical Quality Improvement Program. J Am Coll Surg. 2008;206:953–959. https://doi.org/10.1016/j.jamcollsurg.2008.01.018
    CROSSREF
  • 3.Thompson LH, Nordenström E, Almquist M, Jacobsson H, Bergenfelz A. Risk factors for complications after adrenalectomy: results from a comprehensive national database. Langenbecks Arch Surg. 2017; 402:315–322.
  • 4.Higashihara E, Tanaka Y, Horie S et al. A case report of laparoscopic adrenalectomy. Nippon Hinyokika Gakkai Zasshi 1992; 83: 1130–3. https://doi.org/10.5980/jpnjurol1989.83.1130
    CROSSREF
  • 5.Chai YJ, Kwon H, Yu HW, Kim SJ, Choi JY, Lee KE, Youn YK. Systematic Review of Surgical Approaches for Adrenal Tumors: Lateral Transperitoneal versus Posterior Retroperitoneal and Laparoscopic versus Robotic Adrenalectomy. Int J Endocrinol. 2014;2014:918346. https://doi.org/10.1155/2014/918346
    CROSSREF
  • 6.Ishikawa T, Sowa M, Nagayama M, Nishiguchi Y, Yoshikawa K. Laparoscopic adrenalectomy: comparison with the conventional approach. Surg. Laparosc. Endosc. 1997; 7: 275–80.
  • 7.Pillinger SH, Bambach CP, Sidhu S. Laparoscopic adrenalectomy: a 6-year experience of 59 cases. ANZ J Surg. 2002 Jul;72(7):467-70. https://doi.org/10.1046/j.1445-2197.2002.02453.x
    CROSSREF
  • 8.Valeri A, Bergamini C, Bellantone R, et al. Preface In: Valeri A, Bergamini C, Bellantone R, et al (eds) Surgery of the adrenal gland. Milano: Springer; 2013:v-vi. ISBN: 978-88-470-2586-8
  • 9.Dworak, J., Wysocki, M., Rzepa, A. et al. Laparoscopic adrenalectomy - is it safe in hands of residents in training?. BMC Urol 19, 102 (2019). https://doi.org/10.1186/s12894-019-0538-5
    CROSSREF
  • 10.Danwang C, Agbor VN, Bigna JJ. Obesity and postoperative outcomes of the patients with laparoscopic adrenalectomy: a systematic review and meta-analysis. BMC Surg. 2020;20:194. https://doi.org/10.1186/s12893-020-00848-y
    CROSSREF
  • 11.Zubair AB, Arif MH, Razzaq MT, Zaman M, Haider Z, Fajar IE, Saleem S, Khalil A, Sabir M, Kaneez M. The Spectrum of Postoperative Complications and Outcomes After Open Adrenalectomy: An Experience From a Developing Country. Cureus. 2022 Nov 11;14(11):e31357. https://doi.org/10.7759/cureus.31357
    CROSSREF
  • 12.Cooper AB, Habra MA, Grubbs EG, Bednarski BK, Ying AK, Perrier ND, et al. Does laparoscopic adrenalectomy jeopardize oncologic outcomes for patients with adrenocortical carcinoma? Surg Endosc. 2013;27:4026–32. https://doi.org/10.1007/s00464-013-3034-0
    CROSSREF
  • 13.Fiszer P, Toutounchi S, Pogorzelski R, Krajewska E, Ciesla W, Skórski M. Laparoscopic adrenalectomy – assessing the learning curve. Pol Przegl Chir. 2012; 84:293–7. https://doi.org/10.2478/v10035-012-0049-5
    CROSSREF
  • 14.Guerrieri M, Campagnacci R, De Sanctis A, Baldarelli M, Coletta M, Perretta S. The learning curve in laparoscopic adrenalectomy. J Endocrinol Investig. 2008;31:531–6. https://doi.org/10.1007/BF03346403
    CROSSREF
  • 15.Stefanidis D, Goldfarb M, Kercher KW, Hope WW, Richardson W, Fanelli RD. SAGES guidelines for minimally invasive treatment of adrenal pathology. Surg Endosc. 2013;27:3960–80. https://doi.org/10.1007/s00464-013-3169-z
    CROSSREF
  • 16.Filipponi S, Guerrieri M, Arnaldi G, Giovagnetti M, Masini AM, Lezoche E, Mantero F. Laparoscopic adrenalectomy: a report on 50 operations. Eur J Endocrinol. 1998 May;138(5):548-53. https://doi.org/10.1530/eje.0.1380548
    CROSSREF
  • 17.Wu CT, Chiang YJ, Chou CC, Liu KL, Lee SH, Chang YH, Chuang CK. Comparative study of laparoscopic and open adrenalectomy. Chang Gung Med J. 2006 Sep-Oct;29(5):468-73.
    PUBMED
  • 18.Suzuki K, Ushiyama T, Ihara H, Kageyama S, Mugiya S, Fujita K. Complications of laparoscopic adrenalectomy in 75 patients treated by the same surgeon. Eur Urol. 1999;36(1):40-7. https://doi.org/10.1159/000019925
    CROSSREF
  • 19.Satti MZ, Hamza M, Sajid Z, Asif O, Ahmed H, Zaidi SMJ, Irshad U. Compliance Rate of Surgical Antimicrobial Prophylaxis and its Association with Knowledge of Guidelines Among Surgical Residents in a Tertiary Care Public Hospital of a Developing Country. Cureus. 2019 May 29;11(5):e4776. https://doi.org/10.7759/cureus.4776
    CROSSREF
  • 20.Monahan M, Jowett S, Pinkney T, Brocklehurst P, Morton DG, Abdali Z, Roberts TE. Surgical site infection and costs in low- and middle-income countries: A systematic review of the economic burden. PLoS One. 2020 Jun 4;15(6):e0232960. https://doi.org/10.1371/journal.pone.0232960
    CROSSREF
  • 21.Mihai R. Open adrenalectomy. Gland Surg. 2019 Jul;8(Suppl 1):S28-S35. https://doi.org/10.21037/gs.2019.05.10
    CROSSREF
  • 22.Al-Jalabneh T, Al-Shawabkeh O, Al-Gwairy I, Abu-Zeitoun O, Al-Njadat I, Al-Soudi M, Zarour A. Laparoscopic Versus Open Adrenalectomy: a Retrospective Comparative Study. Med Arch. 2021 Feb;75(1):41-44. https://doi.org/10.5455/medarh.2021.75.41-44
    CROSSREF
  • 23.Staren ED, Prinz RA. Adrenalectomy in the era of laparoscopy. Surgery. 1996 Oct;120(4):706-9; discussion 710-1. https://doi.org/10.1016/s0039-6060(96)80020-1
    CROSSREF
  • 24.Gupta PK, Natarajan B, Pallati PK, Gupta H, Sainath J, Fitzgibbons RJ Jr. Outcomes after laparoscopic adrenalectomy. Surg Endosc. 2011 Mar;25(3):784-94. https://doi.org/10.1007/s00464-010-1256-y
    CROSSREF
  • 25.Ibragimovich KS, Bazarbaevich BU, Parpijalilovich SD. Our Experience Videoendoscopic Adrenalectomy in Patients with Benign Adrenal Tumors Large Sizes. American Journal of Medicine and Medical Sciences. 2017;7(1):11–13. https://doi.org/10.5923/j.ajmms.20170701.03
    CROSSREF
  • 26.Boylu U, Oommen M, Lee BR, Thomas R. Laparoscopic adrenalectomy for large adrenal masses: pushing the envelope. J Endourol. 2009 Jun;23(6):971–975. https://doi.org/10.1089/end.2008.0555
    CROSSREF
  • 27.Fiszer P, Toutounchi S, Pogorzelski R, Krajewska E, Sutkowski B, Gierej P, Skórski M. Is tumour size a contraindication to laparoscopic adrenalectomy? Case report. Wideochir Inne Tech Maloinwazyjne. 2012 Jun;7(2):144-6. https://doi.org/10.5114/wiitm.2011.25931
    CROSSREF
  • 28.Machado NO, Al Qadhi H, Al Wahaibi K, Rizvi SG. Laparoscopic Adrenalectomy for Large Adrenocortical Carcinoma. JSLS. 2015 Jul-Sep;19(3):e2015.00036. https://doi.org/10.4293/JSLS.2015.00036
    CROSSREF
  • 29.Fiori, C., Checcucci, E., Amparore, D., Cattaneo, G., Manfredi, M., & Porpiglia, F. (2020). Adrenal tumours: open surgery versus minimally invasive surgery. Current Opinion in Oncology, 32(1), 27–34. https://doi.org/10.1097/cco.0000000000000594
    CROSSREF
  • 30.Fassnacht, M., Johanssen, S., Quinkler, M., Bucsky, P., Willenberg, H.S., Beuschlein, F., Terzolo, M., Mueller, H.-H., Hahner, S., Allolio, B. and (2009), Limited prognostic value of the 2004 International Union Against Cancer staging classification for adrenocortical carcinoma. Cancer, 115: 243-250. https://doi.org/10.1002/cncr.24030
    CROSSREF
  • 31.Geubbels N, de Brauw LM, Acherman YI, van de Laar AW, Wouters MW, Bruin SC. The Preceding Surgeon Factor in Bariatric Surgery: a Positive Influence on the Learning Curve of Subsequent Surgeons. Obes Surg. 2015 Aug;25(8):1417-24. https://doi.org/10.1007/s11695-014-1538-x
    CROSSREF
  • 32.Arezzo A, Bullano A, Cochetti G, Cirocchi R, Randolph J, Mearini E, Evangelista A, Ciccone G, Bonjer HJ, Morino M. Transperitoneal versus retroperitoneal laparoscopic adrenalectomy for adrenal tumours in adults. Cochrane Database Syst Rev. 2018 Dec 30;12(12):CD011668. https://doi.org/10.1002/14651858.CD011668
    CROSSREF

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