Laparoscopic Adrenalectomy: First Single-Center Experience in the Balkans

Popov, Z̆.; Јankulovski, Nikola; Stankov, Oliver; Stavridis, Sotir; Saidi, Skender; Kuzmanoski, M.; Chipurovski, Igor; Banev, S.; Krstevska, Brankica; Dimitrovski, Chedomir

doi:10.1515/prilozi-2015-0075

Cited by 4 publications

(6 citation statements)

References 16 publications

(16 reference statements)

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“…The choice of LA over open approach is not related only to smaller incisions and better exposure. In the present study, we found that estimated intraoperative blood loss was significantly less with LA, which is consistent with other studies ( 2 , 21 , 24 ). Also, the postoperative hospital stay length was significantly less with the laparoscopic approach, a finding that has been proved by most other authors ( 2 , 6 , 21 - 26 ).…”

Section: Discussionsupporting

confidence: 93%

“…In the present study, we found that estimated intraoperative blood loss was significantly less with LA, which is consistent with other studies ( 2 , 21 , 24 ). Also, the postoperative hospital stay length was significantly less with the laparoscopic approach, a finding that has been proved by most other authors ( 2 , 6 , 21 - 26 ). The operation time was found in our study to be less with LA in keeping with other studies ( 21 , 24 , 25 ), although others found that this time was similar ( 2 ) to open approach or even longer ( 6 ).…”

Section: Discussionsupporting

confidence: 93%

“…Also, the postoperative hospital stay length was significantly less with the laparoscopic approach, a finding that has been proved by most other authors ( 2 , 6 , 21 - 26 ). The operation time was found in our study to be less with LA in keeping with other studies ( 21 , 24 , 25 ), although others found that this time was similar ( 2 ) to open approach or even longer ( 6 ). Of note, we found that operative time, estimated blood loss and hospital stay were significantly increased as the size of the tumor increased.…”

Section: Discussionsupporting

confidence: 75%

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Laparoscopic Versus Open Adrenalectomy: a Retrospective Comparative Study

Al-Jalabneh¹,

Al-Shawabkeh²,

Al-Gwairy³

et al. 2021

Med Arch

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Background: Laparoscopic Adrenalectomy (LA) has rapidly become the gold standard in management of adrenal tumors as it has been found to be associated with better cosmoses, shorter hospital stay and rapid convalescence. Objective: The aim of this study was to compare laparoscopic and open approach to adrenal glands in terms of operative time, hospital stay, indications and blood loss at a tertiary medical center in Jordan. Methods: A retrospective comparative study which included all patients who underwent adrenalectomy (open or laparoscopic) from 2005 to 2015 at King Hussein Medical Center (KHMC). Patients’ demographics ,outcomes and essential study variables were extracted from patients’ files. Data analysis was performed using SPSS17 and Stata 10. Results: One hundred and three patients (mean age 44.9 years) were included, 90.2% of them underwent laparoscopic adrenalectomy. The size of the tumors ranged from 2 to 17 cm (mean 6.6 cm).The operative time, blood loss and hospital stay were significantly less in the laparoscopic group (P value <0.001). Patients in Open group had a significantly higher risk of incomplete excision of the tumors (P value=0.020). Conclusion: Laparoscopic adrenalectomy is associated with decreased operative time, blood loss and hospital stay compared to open approach. Tumor size and its malignant potential should be no more regarded as an absolute contraindication to laparoscopic adrenal surgery.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 75%

See 1 more Smart Citation

Laparoscopic Versus Open Adrenalectomy: a Retrospective Comparative Study

Al-Jalabneh¹,

Al-Shawabkeh²,

Al-Gwairy³

et al. 2021

Med Arch

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“…Laparoscopic surgery has gradually replaced open surgery as gold standard for the management of adrenal tumors [ 17 , 29 – 33 ]. Although indications for this approach were initially limited to benign tumors, they gradually expanded to include malignant tumors, making laparoscopy the preferred approach for adrenal gland surgery [ 30 – 32 , 34 , 35 ]. However, laparoscopic adrenalectomy is said to be technically difficult in patients with obesity given the retroperitoneal localization of adrenal glands.…”

Section: Introductionmentioning

confidence: 99%

Obesity and postoperative outcomes of the patients with laparoscopic adrenalectomy: a systematic review and meta-analysis

2020

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Background: Studies have suggested differences in postoperative outcomes between patients with obesity and those without following adrenalectomy, but these remained to be ascertained with synthesis of available evidence. The aim of this systematic review and meta-analysis was to investigate the association between obesity and outcomes of patients after laparoscopic adrenalectomy. Methods: We searched EMBASE, PubMed, Global Index Medicus, and Web of Science, without language restriction, to identify cohort studies published between January 1, 2000 and November 6, 2019. We considered studies with data comparing outcomes of adults with and without obesity after laparoscopic adrenalectomy. Random-effects meta-analysis was used to pool study-specific estimates. This review was registered with PROSPERO, CRD42018117070. Results: Five studies with data on a pooled sample of 353 patients with obesity and 828 without were included in the meta-analysis. The risk of bias was moderate to low. We found no association between obesity and the various stages of postoperative complications: Clavien-Dindo grade 1 (OR = 1.57; 95%CI = 0.55-4.48; I 2 = 44.6%), grade 2 (OR = 1.12; 95%CI = 0.54-2.32; I 2 = 0.0%), grade 3 (OR = 1.79; 95%CI = 0.58-5.47; I 2 = 0.0%;), grade 4 (OR = 0.43; 95%CI = 0.05-3.71; I 2 = 0.0%), and grade 5 (death) (OR = 0.43; 95% CI = 0.02-14.31). Furthermore, no association was found between obesity and readmission rates (OR = 0.7; 95% CI = 0.13-3.62) and conversion of laparoscopic to open surgery (OR = 0.62; 95% CI = 0.16-2.34; I 2 = 19.5%). Conclusions: This study suggests that obesity is not associated with complications following laparoscopic adrenalectomy. This meta-analysis might have been underpowered to detect a true association between obesity and patient outcome after laparoscopic adrenalectomy due to the small number of included studies. Larger studies are needed to clarify the role of obesity in patients undergoing laparoscopic adrenalectomy.

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“…Low-volume series are also found in the literature predominantly from developing countries where centralisation might be scarce hence the authors reported 34 adrenalectomies in 10 years in Saudi Arabia (a mean of 3/year) [35], or 46 adrenalectomies in 6 years in Thailand (7.6/year) [36] or 35 adrenalectomies over 12 years in three different hospitals (1 adrenalectomy/year/hospital) [37].…”

Section: What Is the Individual Workload Of Adrenal Surgery Reported mentioning

confidence: 99%

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

Mihai

Donatini

Vidal

et al. 2019

Langenbecks Arch Surg

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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.

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Laparoscopic Adrenalectomy: First Single-Center Experience in the Balkans

Abstract: Our results concur with other retrospective reviews comparing laparoscopic and open adrenalectomy, demonstrating unequivocal advantages in terms of reduced length of hospital stay, blood loss, return of bowel function, functional recovery and post-operative morbidity.

Cited by 4 publications

References 16 publications

Laparoscopic Versus Open Adrenalectomy: a Retrospective Comparative Study

Laparoscopic Versus Open Adrenalectomy: a Retrospective Comparative Study

Obesity and postoperative outcomes of the patients with laparoscopic adrenalectomy: a systematic review and meta-analysis

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

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