Lateral retroperitoneoscopic adrenalectomy: advantages and drawbacks

Grozdev, Konstantin; Khayat, Nabil; Shumarova, Svetlana; Ivanova, Gergana; Angelov, Kostadin; Todorov, Georgi

doi:10.1007/s13304-020-00741-6

Cited by 2 publications

(1 citation statement)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The findings of several studies highlight an issue regarding the maximal tumor diameter of retroperitoneoscopic adrenal tumor excision ( 29 - 32 ). As tumors increase in size, their contact surface with surrounding fat, surrounding organs, and other tissues likewise increases; that is, the area to be dissected and operative space increase accordingly, thereby increasing the operating time and difficulty of the operation.…”

Section: Discussionmentioning

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

Section: Discussionmentioning

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

show abstract

Lateral retroperitoneal adrenalectomy: Comparison of introduction and education periods of a new surgical procedure in a teaching hospital. A retrospective case series study

Endo

Morishima

Koizumi

et al. 2022

International Journal of Surgery Open

View full text Add to dashboard Cite

Introduction Lateral retroperitoneal adrenalectomy (LRPA) was introduced to a teaching hospital. A fixed operating team of experienced surgeons and a step-by-step educational approach were employed. Surgical outcomes during the study period are analyzed. The safety of this process was evaluated. Methods In this case series study, data for all patients who underwent LRPA from 2006 to 2020 were retrospectively reviewed. Patients were divided into two groups according to when surgery was performed, the introduction period, and the subsequent education period. All data were compared between the two groups. Three surgeons were certified as independent surgeons during the education period. The outcomes of procedures performed by these three surgeons as trainees were compared. Results A total of 179 patients underwent LRPA with 53 patients during the introduction period and 126 patients during the education period. There was no significant difference between the two groups regarding operating time (129min vs 134min, p = 0.63) or estimated blood loss (63 ml vs 43 ml, p = 0.36). There were no significant differences in conversion to other procedures or perioperative complications. Among the three surgeons certified as independent surgeons during the education period, there were no significant differences in operating time (140min vs 120min vs 149min, p = 0.056), estimated blood loss (31 ml vs 28 ml vs 42 ml, p = 0.874), conversion to other procedures, perioperative complication rate, or postoperative length of stay. There was no evidence of a learning curve effect. Conclusion LRPA as a new procedure was safely introduced to a teaching hospital and safely promulgated to trainees. Graphical abstract Highlights

show abstract

Lateral retroperitoneoscopic adrenalectomy: advantages and drawbacks

Cited by 2 publications

References 43 publications

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

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

Lateral retroperitoneal adrenalectomy: Comparison of introduction and education periods of a new surgical procedure in a teaching hospital. A retrospective case series study

Contact Info

Product

Resources

About