Mayo Adhesive Probability Score Is Associated with the Operative Time in Laparoscopic Adrenalectomy

2021 ◽  
Author(s):  
Satoru Kira ◽  
Norifumi Sawada ◽  
Hiroshi Nakagomi ◽  
Tatsuya Ihara ◽  
Ryouta Furuya ◽  
...  
Keyword(s):  
Laparoscopic Adrenalectomy ◽  
Operative Time ◽  
Probability Score

scholarly journals Comparison of robot-assisted retroperitoneal laparoscopic adrenalectomy versus retroperitoneal laparoscopic adrenalectomy for large pheochromocytoma: a single-centre retrospective study

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sheng-Qiang Fu ◽  
Chang-Shui Zhuang ◽  
Xiao-Rong Yang ◽  
Wen-Jie Xie ◽  
Bin-Bin Gong ◽  
...  
Keyword(s):  
Laparoscopic Adrenalectomy ◽  
Operative Time ◽  
Haemodynamic Instability ◽  
Robot Assisted ◽  
Improvement Rate ◽  
Long Term Follow Up ◽  
Tumour Characteristics ◽  
Group 1

Abstract Background To evaluate the feasibility and safety of robot-assisted retroperitoneal laparoscopic adrenalectomy (RARLA) for large pheochromocytomas (PHEOs; size≥6 cm) compared with retroperitoneal laparoscopic adrenalectomy (RLA). Methods Fifty-one patients who underwent adrenalectomy for large PHEOs between March 2016 and January 2019 were enrolled and divided into two groups, including 32 RLA cases and 19 RARLA cases. We compared the perioperative efficacy and long-term follow-up results between the two groups. Results Preoperative data, including demographics, comorbidities and tumour characteristics, were similar between the groups. Intraoperatively, the RARLA group had a lower incidence of haemodynamic instability (26.3% vs. 56.2%, P = 0.038) and less intraoperative blood loss (100 ml vs. Two hundred milliliter, P = 0.042) than the RLA group. The groups showed no significant differences in operative time or transfusion rates. Postoperatively, the time to diet resumption, time to ambulation, time to drainage removal and postoperative hospital stay were shorter in the RARLA group than in the RLA group (1 d vs. 2 d, P = 0.027; 1 d vs. 2 d, P = 0.034; 3 d vs. 5 d, P = 0.002; 5 d vs. 6 d, P = 0.02, respectively). The groups exhibited no significant differences in the duration of anaesthetic use, complications, or long-term follow-up results for the blood pressure (BP) improvement rate. Conclusions Compared with RLA, RARLA is a safe, feasible and even optimized procedure for large PHEOs.

scholarly journals Patient-reported satisfaction and cosmesis outcomes following laparoscopic adrenalectomy: laparoendoscopic single-site adrenalectomy vs. conventional laparoscopic adrenalectomy

2014 ◽  
Vol 8 (1-2) ◽  
pp. 20 ◽  
Author(s):  
Shogo Inoue ◽  
Kenichiro Ikeda ◽  
Kanao Kobayashi ◽  
Mitsuru Kajiwara ◽  
Jun Teishima ◽  
...  
Keyword(s):  
Laparoscopic Adrenalectomy ◽  
Operative Time ◽  
Young Patients ◽  
Satisfaction Score ◽  
Single Site ◽  
Female Patients ◽  
Conventional Laparoscopic ◽  
Laparoendoscopic Single Site ◽  
Estimated Blood Loss ◽  
Patient Reported

Introduction: We evaluate patient-reported satisfaction and cosmesis of laparoendoscopic single-site adrenalectomy (LESS-A) in comparison with that of conventional laparoscopic adrenalectomy (CLA).Methods: A total of 19 and 104 patients who respectively underwent LESS-A and CLA between May 1996 and June 2011 were included in the study. Questionnaires inquiring about scar pain (0: not painful, 10: very painful), satisfaction (0: not satisfied, 10:very satisfied) and cosmesis (0: very unsightly, 10: very beautiful) on the basis of a visual analogue scale were sent to patients postoperatively.Results: The respondents consisted of 11 and 54 patients who underwent LESS-A and CLA, respectively. There was no significant inter-group difference in age, sex, affected side or body mass index. No significant differences were observed in operative time or estimated blood loss. There were also no significant differences in pain (0.67 vs. 0.57, p = 0.393), satisfaction (8.92 vs. 8.46, p = 0.453), or cosmesis score (8.58 vs. 8.00, p = 0.487) between the LESS-A and CLA groups overall. In female patients, the satisfaction score was significantly higher in the LESS-A group than in the CLA group (10.0 vs. 8.72, p = 0.049). In young patients (<50 years old), the satisfaction score was also significantly higher in the LESS-A group than in the CLA group (9.17 vs. 6.38, p = 0.036).Conclusions: Young patients and female patients who had received LESS-A adrenal surgery were more satisfied with the scar outcomes than were the young patients and female patients who had received CLA. We suggest that this patient subset most values the cosmetic benefits of LESS-A.

Impact of Obesity on Perioperative Outcomes of Retroperitoneal Laparoscopic Adrenalectomy

2015 ◽  
Vol 95 (3) ◽  
pp. 361-366 ◽  
Author(s):  
Qingfeng Hu ◽  
Zhenyu Hang ◽  
Yaatfat Ho ◽  
Chuanyu Sun ◽  
Ke Xu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Postoperative Complications ◽  
Laparoscopic Adrenalectomy ◽  
Operative Time ◽  
Multivariate Logistic Regression Analysis ◽  
Perioperative Outcomes ◽  
Estimated Blood Loss ◽  
Overweight Group ◽  
Postoperative Length ◽  
The Impact

Introduction: Obesity is usually considered a risk factor for postoperative complications; however, previous studies conclude contradictory results in retroperitoneal laparoscopic adrenalectomy (LA). We aim to evaluate the impact of obesity on the perioperative outcomes of LA. Methods: A retrospective cohort study from a single center including 353 patients from 2011 to 2013 was conducted. Perioperative outcomes of patients from different groups were compared according to their body mass index (BMI). Results: All the patients were divided into 3 groups: normal (n = 149), overweight (n = 141) and obese (n = 63). Operative time (OT) for patients belonging to the obese group was significantly longer than that in the normal and overweight group, and the results of estimated blood loss, postoperative length of stay in hospital and postoperative complications were all similar. In the multivariate logistic regression analysis, OT was an independent risk factor for postoperative complications (odds ratio 1.020; 95% confidence interval 1.001-1.039; p = 0.037), while other factors including BMI had negligible effect. Conclusions: Retroperitoneal LA offers similar perioperative outcomes for patients with different obesity statuses, which could be safe and feasible for obese patients.

scholarly journals Comparison of lateral transperitoneal and retroperitoneal approaches for homolateral laparoscopic adrenalectomy

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhao Liu ◽  
Da-wei Li ◽  
Lei Yan ◽  
Zhong-Hua Xu ◽  
Gang-li Gu
Keyword(s):  
Blood Loss ◽  
Laparoscopic Adrenalectomy ◽  
Operative Time ◽  
Oral Intake ◽  
Patient Characteristics ◽  
Retroperitoneal Approach ◽  
Perioperative Outcomes ◽  
Transperitoneal Approach ◽  
Operative Data

Abstract Background There is a lack of data regarding the appropriateness of transperitoneal and retroperitoneal approaches for homolateral laparoscopic adrenalectomy. The aim of this study is to compare lateral transperitoneal and retroperitoneal approach for left-sided and right-sided laparoscopic adrenalectomy respectively. Methods Between January 2014 and December 2019, 242 patients underwent left-sided and 252 patients underwent right-sided laparoscopic adrenalectomy. For left side, transperitoneal approach was used in 132 (103 with tumors < 5 cm and 29 with tumors ≥ 5 cm) and retroperitoneal approach in 110 (102 with tumors < 5 cm and 8 with tumors ≥ 5 cm). For right side, transperitoneal approach was used in 139 (121 with tumors < 5 cm and 18 with tumors ≥ 5 cm) and retroperitoneal approach in 113 (102 with tumors < 5 cm and 11 with tumors ≥ 5 cm). Patient characteristics and perioperative outcomes were recorded. For each side, both approaches were compared for tumors < 5 cm and ≥ 5 cm respectively. Results For left-sided tumors < 5 cm, transperitoneal approach demonstrated shorter operative time, less blood loss and longer time to oral intake. For left-sided tumors ≥ 5 cm, the peri-operative data of both approaches was comparable. For right-sided tumors < 5 cm, transperitoneal approach demonstrated shorter operative time and less blood loss. For right-sided tumors ≥ 5 cm, the peri-operative data was comparable. Conclusions Lateral transperitoneal and retroperitoneal approach are both effective for laparoscopic adrenalectomy. Lateral transperitoneal approach is faster with less blood loss for tumors < 5 cm.

scholarly journals The Optimal Approach for Laparoscopic Adrenalectomy through Mono Port regarding Left or Right Sides: A Comparative Study

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Wooseok Byon ◽  
Keehoon Hyun ◽  
Ji-Sup Yun ◽  
Yong Lai Park ◽  
Chan Heun Park
Keyword(s):  
Surgical Outcomes ◽  
Laparoscopic Adrenalectomy ◽  
Adrenal Glands ◽  
Operative Time ◽  
Oral Intake ◽  
Patient Characteristics ◽  
Posterior Retroperitoneal Approach ◽  
Optimal Approach ◽  
The Right ◽  
Length Of Hospitalization

Introduction.Several studies have shown the feasibility and safety of both transperitoneal and posterior retroperitoneal approaches for single incision laparoscopic adrenalectomy, but none have compared the outcomes according to the left- or right-sided location of the adrenal glands.Materials and Methods.From 2009 to 2013, 89 patients who received LAMP (laparoscopic adrenalectomy through mono port) were analyzed. The surgical outcomes attained using the transperitoneal approach (TPA) and posterior retroperitoneal approach (PRA) were analyzed and compared.Results and Discussion.On the right side, no significant differences were found between the LAMP-TPA and LAMP-PRA groups in terms of patient characteristics and clinicopathological data. However, outcomes differed in which LAMP-PRA group had a statistically significant shorter mean operative time (84.13 ± 41.47 min versus 116.84 ± 33.17 min;P=0.038), time of first oral intake (1.00 ± 0.00 days versus 1.21 ± 0.42 days;P=0.042), and length of hospitalization (2.17 ± 0.389 days versus 3.68 ± 1.38 days;P≤0.001), whereas in left-sided adrenalectomies LAMP-TPA had a statistically significant shorter mean operative time (83.85 ± 27.72 min versus 110.95 ± 29.31 min;P=0.002).Conclusions.We report that LAMP-PRA is more appropriate for right-sided laparoscopic adrenalectomies due to anatomical characteristics and better surgical outcomes. For left-sided laparoscopic adrenalectomies, however, we propose LAMP-TPA as a more suitable method.

Impact of Surgical Mentorship on Retroperitoneoscopic Adrenalectomy with Comparison to Transperitoneal Laparoscopic Adrenalectomy

2013 ◽  
Vol 79 (2) ◽  
pp. 162-166
Author(s):  
James T. Broome ◽  
Carmen C. Solorzano
Keyword(s):  
Blood Loss ◽  
Laparoscopic Adrenalectomy ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
High Volume ◽  
Perioperative Outcomes ◽  
Adrenal Tumors ◽  
Retroperitoneoscopic Adrenalectomy ◽  
The Mean ◽  
The Impact

Retroperitoneoscopic adrenalectomy (RA) provides a direct approach to the adrenal gland. RA represents a complex approach with unique orientation that is less intuitive. The authors objectively evaluated the impact of mentorship on the performance of RA and also compared it with laparoscopic adrenalectomy (LA). After implementing the use of RA, a retrospective review of the operative experience of two high-volume endocrine surgeons was performed. Both surgeons participated in a hands-on RA mentorship. Clinical presentation and perioperative outcomes were compared. Subgroup analysis was used to compare RA pre- and postmentorship and with LA. Sixty-one LAs and 31 RAs were included in the analysis. The mean operative time was 115 for LA versus 90 minutes for RA ( P = 0.002). Blood loss was greater for LA versus RA (56 vs 22 mL; P = 0.001). Length of stay (LOS) for LA was 2.2 versus 1.5 days for RA ( P = 0.029). Ten patients were treated by RA in the prementorship era versus 21 in the postmentorship era. The mean operative time for the prementorship group was 118 minutes, which decreased to 77 minutes postmentorship ( P < 0.0001). LOS also decreased from 2.0 to 1.2 days ( P = 0.04) in the postmentorship era. RA demonstrates a shorter operative time, less blood loss, and decrease length of hospital stay as compared with standard LA. After proper mentorship and patient selection, RA may represent a superior option for removal of small, benign adrenal tumors.

scholarly journals Comparison of Posterior Retroperitoneoscopic Adrenalectomy Versus Lateral Transperitoneal Laparoscopic Adrenalectomy for Adrenal Tumors: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Chunyang Meng ◽  
Chunxiao Du ◽  
Lei Peng ◽  
Jinze Li ◽  
Jinming Li ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Laparoscopic Adrenalectomy ◽  
Conversion Rate ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Adrenal Tumors ◽  
Retroperitoneoscopic Adrenalectomy ◽  
Estimated Blood Loss ◽  
Posterior Retroperitoneoscopic Adrenalectomy

ObjectiveTo discuss the differences in the effectiveness and security for adrenal tumors by posterior retroperitoneoscopic adrenalectomy (PRA) and lateral transperitoneal laparoscopic adrenalectomy (LTA).MethodsWe systematically searched PubMed, Embase, Scopus database and Cochrane Library, and the date was from above database establishment to November 2020. Stata 16 was used for calculation and statistical analyses.ResultsNine studies involving eight hundred patients were included. The following differences were observed in favor of PRA vs LTA: less operative time (MD: −22.5; 95% CI −32.57 to −12.45; P=0.000), Fewer estimated blood loss (MD: −15.17; 95% CI −26.63 to −3.72; P=0.009), lower intensity of postoperative pain (MD: −0.56; 95% CI, −1.05 to −0.07; P=0.026), shorter length of hospital stay (MD: −1.15; 95% CI −1.94 to −0.36; P=0.04). No differences were shown in conversion rate (OR 2.07; 95%CI 0.71 to 6.03; P=0.181) and complications (OR 0.85;95% CI 0.46 to 1.56; P=0.597).ConclusionsPosterior retroperitoneoscopic adrenalectomy was clinically superior to lateral transperitoneal laparoscopic adrenalectomy for adrenal tumors in operative time, estimated blood loss, length of hospital stay, and postoperative pain. Only in term of conversion rate and complications, both were similar

Visceral Fat Is Correlated With Prolonged Operative Time in Laparoendoscopic Single-site Adrenalectomy and Laparoscopic Adrenalectomy

Urology ◽  
2013 ◽  
Vol 82 (6) ◽  
pp. 1312-1319 ◽  
Author(s):  
Masanori Hasegawa ◽  
Akira Miyajima ◽  
Masahiro Jinzaki ◽  
Takahiro Maeda ◽  
Toshikazu Takeda ◽  
...  
Keyword(s):  
Visceral Fat ◽  
Laparoscopic Adrenalectomy ◽  
Operative Time ◽  
Single Site ◽  
Laparoendoscopic Single Site ◽  
Prolonged Operative Time

Comparison of Outcomes between Obese and Nonobese Patients in Laparoscopic Adrenalectomy: A Cohort Study

2021 ◽  
pp. 1-10
Author(s):  
José Ignacio Rodríguez-Hermosa ◽  
Pere Planellas-Giné ◽  
Lídia Cornejo ◽  
Jordi Gironès ◽  
Mònica Recasens ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Loss ◽  
Laparoscopic Adrenalectomy ◽  
Operative Time ◽  
Cushing Syndrome ◽  
Adrenal Tumors ◽  
Obese Patients ◽  
Estimated Blood Loss ◽  
Observational Cohort ◽  
Nonobese Patients

<b><i>Introduction:</i></b> Obesity is usually considered a risk factor for surgical complications. Laparoscopic adrenalectomy has replaced open adrenalectomy as the standard operation for adrenal tumors. <b><i>Objective:</i></b> To compare the safety of laparoscopic adrenalectomy to treat adrenal tumors in obese versus nonobese patients. <b><i>Methods:</i></b> This observational cohort study analyzed consecutive patients who underwent laparoscopic adrenalectomy with a lateral transperitoneal approach at a single center (2003–2020). Data and outcomes of obese (body mass index ≥30 kg/m<sup>2</sup>) and nonobese patients were compared. To analyze the association between operative time and other variables, we used simple and multivariate linear regression. <b><i>Results:</i></b> <i>N</i> = 160 (90 obese/70 nonobese) patients underwent laparoscopic adrenalectomy. Cushing syndrome and pheochromocytoma were the most frequent indications. Obese patients were older (58 vs. 52 years, <i>p</i> &#x3c; 0.001). A greater proportion of obese patients were ASA grade III + IV (71.1 vs. 48.6%, <i>p</i> = 0.004). Obesity was associated with a longer operative time (72.5 vs. 60 min, <i>p</i> &#x3c; 0.001) and greater blood loss (40 vs. 20 mL, <i>p</i> = 0.022). There were no differences in conversion, morbidity, or hospital stay. After adjustment for confounding factors, operative time was positively correlated with BMI ≥30 kg/m<sup>2</sup>, learning curve, estimated blood loss, 2D laparoscopy, and specimen size. <b><i>Conclusion:</i></b> Lateral transperitoneal laparoscopic adrenalectomy is safe in patients with a BMI 30–35 kg/m<sup>2</sup>, so these patients also benefit from this minimally invasive surgery.

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