Patient selection and outcomes of laparoscopic transabdominal versus posterior retroperitoneal adrenalectomy among surgeons in the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP)

Marrero, Annette Pascual; Kazaure, Hadiza S.; Thomas, Samantha M.; Stang, Michael T.; Scheri, Randall P.

doi:10.1016/j.surg.2019.03.034

Cited by 17 publications

(8 citation statements)

References 19 publications

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“…Although LA has been the gold standard in the removal of adrenal tumors, recently, RA has received attention for possible intraoperative benefits of articulation, three-dimensional view, and increased dexterity compared to laparoscopic instruments. 7,15,20,21 It is important to strictly adhere to surgical oncologic principles when resecting pheochromocytomas, as recurrences can be seen in 6%-16.5% of patients in follow-up, with about half involving the resection bed and retroperitoneum. 24 Tumor size larger than 5 cm independently predicts recurrence.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic versus robotic adrenalectomy in pheochromocytoma patients

Isiktas

Avci

Ergun

et al. 2022

Journal of Surgical Oncology

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Background and Objectives Pheochromocytoma is a challenging tumor type requiring resection with a clear margin and an intact capsule to prevent recurrences. Our aim was to compare perioperative outcomes of laparoscopic adrenalectomy (LA) versus robotic adrenalectomy (RA) for pheochromocytoma. Methods In an institutional review board‐approved retrospective study, clinical parameters of patients who underwent LA versus RA at a single center were compared using Mann–Whitney U, χ2, and survival analyses. Continuous data are expressed as median (interquartile range). Results There was a total of 157 patients (RA: n = 87, LA: n = 70) analyzed. Estimated blood loss (36.3 [35.0] vs. 99.9 [65.0] cc, p = 0.020) and hospital stay (1.3 [0.0] vs. 2.2 [1.0] days, p = 0.010) were lower in robotic versus laparoscopic group, respectively. Disease‐free and overall survival was similar between groups. The rate of conversion to open for tumors ≥5 cm was less in the robotic group (0% vs. 14%, respectively, p = 0.048). Conclusion In this study, long‐term outcomes of LA and RA were similar, although adrenalectomies performed robotically were associated with less blood loss, shorter hospital stay, and a lower chance of conversion to open in the case of large tumors.

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Section: Discussionmentioning

confidence: 99%

“…Although LA has been the gold standard in the removal of adrenal tumors, recently, RA has received attention for possible intraoperative benefits of articulation, three‐dimensional view, and increased dexterity compared to laparoscopic instruments 7,15,20,21 . Ma et al 22 randomized 70 patients each to RA versus LA.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic versus robotic adrenalectomy in pheochromocytoma patients

Isiktas

Avci

Ergun

et al. 2022

Journal of Surgical Oncology

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“…La surrenectomia transaddominale laparoscopica (TAL) o retroperitoneoscopica posteriore (RP) sono diventate le procedure standard per i tumori surrenali non invasivi, primari e metastatici negli ultimi 25 anni [1]. Contrariamente all'approccio RP, l'approccio TAL consente un ulteriore spazio di lavoro con riferimenti anatomici convenzionali degli organi [1,2]. Vari studi presso singoli Centri hanno dimostrato che i risultati delle due procedure non differiscono in modo significativo l'uno dall'altro ma che il RP può offrire vantaggi per i pazienti con tumori più piccoli, indice di massa corporea inferiore (BMI), patologie bilaterali e con patologie addominali, operazioni addominali precedenti.…”

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“…Lo scopo dello studio di Marrero e collaboratori è stato quello di esaminare se possono essere identificate differenze qualitative tra le due procedure endoscopiche sulla base del programma multi-istituzionale statunitense American Collaborative Endocrine Surgery Quality Improvement Program (CESQIP) [2]. In dettaglio, sono stati valutati i dati presentati da 34 centri al programma CESQIP tra il 2014 e il 2018.…”

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Criteri di selezione per surrenectomia laparoscopica o retroperitoneoscopica

Calò

Dionigi

2020

L'Endocrinologo

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Laparoscopic versus robotic lateral transabdominal adrenalectomy

Isiktas,

Akgun,

Berber

2023

Journal of Surgical Oncology

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Background and ObjectivesDespite an increased adaptation of robotic adrenalectomy, its advantages over laparoscopic adrenalectomy (LA) have not been defined. The aim of the study was to compare perioperative outcomes of robotic versus laparoscopic lateral transabdominal adrenalectomy using a large single‐center experience.MethodsThis was a retrospective single center study. Within 22 years, patients who underwent laparoscopic and robotic transabdominal lateral adrenalectomy were identified from a prospective institutional review board‐approved database. Clinical and perioperative outcomes were compared using Mann−Whitney U and χ2 tests.ResultsThere were 190 patients who underwent laparoscopic and 281 patients who underwent robotic transabdominal lateral adrenalectomy. The groups were comparable except for a higher percentage of female patients in the robotic group. For robotic versus LA, operative time and hospital stay were shorter, in addition to less blood loss, conversion to open and margin positivity, for pheochromocytoma and malignant tumors. Morbidity rates were similar between the two groups.ConclusionsDespite the limitations of a retrospective design, this large study demonstrates significant advantages of robotic versus laparoscopic transabdominal lateral adrenalectomy in terms of perioperative outcomes and margin clearance.

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Patient selection and outcomes of laparoscopic transabdominal versus posterior retroperitoneal adrenalectomy among surgeons in the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP)

Cited by 17 publications

References 19 publications

Laparoscopic versus robotic adrenalectomy in pheochromocytoma patients

Laparoscopic versus robotic adrenalectomy in pheochromocytoma patients

Criteri di selezione per surrenectomia laparoscopica o retroperitoneoscopica

Laparoscopic versus robotic lateral transabdominal adrenalectomy

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