retroperitoneoscopic adrenalectomy
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Author(s):  
Allon van Uitert ◽  
Elle C. J. van de Wiel ◽  
Jordache Ramjith ◽  
Jaap Deinum ◽  
Henri J. L. M. Timmers ◽  
...  

Abstract Background Posterior retroperitoneoscopic adrenalectomy (PRA) has several advantages over transperitoneal laparoscopic adrenalectomy (TLA) regarding operative time, blood loss, postoperative pain, and recovery. However, it can be a technically challenging procedure. To improve patient selection for PRA, we developed a preoperative nomogram to predict operative time. Methods All consecutive patients with tumors of ≤ 7 cm and a body mass index (BMI) of < 35 kg/m2 undergoing unilateral PRA between February 2011 and March 2020 were included in the study. The primary outcome was operative time as surrogate endpoint for surgical complexity. Using ten patient variables, an optimal prediction model was created, with a best subsets regression analysis to find the best one-variable up to the best seven-variable model. Results In total 215 patients were included, with a mean age of 52 years and mean tumor size of 2.4 cm. After best subsets regression analysis, a four-variable nomogram was selected and calibrated. This model included sex, pheochromocytoma, BMI, and perinephric fat, which were all individually significant predictors. This model showed an ideal balance between predictive power and applicability, with an R2 of 38.6. Conclusions A four-variable nomogram was developed to predict operative time in PRA, which can aid the surgeon to preoperatively identify suitable patients for PRA. If the nomogram predicts longer operative time and therefore a more complex operation, TLA should be considered as an alternative approach since it provides a larger working space. Also, the nomogram can be used for training purposes to select patients with favorable characteristics when learning this surgical approach.


2021 ◽  
Vol 13 (1) ◽  
pp. 16-19
Author(s):  
Kithsiri J Senanayake ◽  
Mechteld C de Jong ◽  
Bahram Jafar-Mohammadi ◽  
Shahab Khan ◽  
Radu Mihai

Author(s):  
D. Vazquez-Martul ◽  
M.A. García-Expósito ◽  
S. Rodríguez-Rey ◽  
R. García-Sobrino ◽  
A. Barbagelata-López ◽  
...  

2021 ◽  
Vol 11 ◽  
Author(s):  
Chunyang Meng ◽  
Chunxiao Du ◽  
Lei Peng ◽  
Jinze Li ◽  
Jinming Li ◽  
...  

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


Author(s):  
Georgina Ferret Granés ◽  
Clara Gené Skrabec ◽  
Jordi Tarascó Palomares ◽  
Ana Torres Marí ◽  
Albert Caballero Boza ◽  
...  

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