TY - JOUR
T1 - Retroperitoneal laparoscopic adrenalectomy for large adrenal tumors—analysis of tumor size and adverse events
T2 - a retrospective single-center study
AU - Tsai, I. Chen
AU - Hsieh, Yu Che
AU - Tseng, Wen Hsin
AU - Liu, Chien Liang
AU - Ho, Chung Han
AU - Li, Chien Feng
AU - Chiu, Allen W.
AU - Huang, Steven K.
N1 - Publisher Copyright:
2024 Tsai, Hsieh, Tseng, Liu, Ho, Li, Chiu and Huang.
PY - 2023
Y1 - 2023
N2 - Introduction: Adrenal tumors are relatively common, and adrenalectomy is the third most common endocrine surgery. Patients with adrenal tumors were categorized into two groups for analysis: those with intermediate (4–6 cm, Group 1) and large (>6 cm, Group 2) tumors undergoing Retroperitoneal Laparoscopic Adrenalectomy (RLA). The primary outcome is to compare the surgical outcomes between these two groups. The secondary outcome involves analyzing the relationship between tumor characteristics and the incidence of adverse events. Methods: Data from 76 patients who underwent RLA for tumors of size ≥4 cm between 2005 and 2022 at a single tertiary referral center were analyzed retrospectively. Variables, including patients' age, hormone function, operation time, conversion to open approach, perioperative complications, and adverse surgical events (blood loss >500 cc, conversion to open approach, and perioperative complications), were assessed. Results: No significant differences were observed between the two groups in terms of functional and histopathologic analysis, gender distribution, functioning factors, perioperative complications, and estimated blood loss. However, patients in Group 2 were younger (median age 50, IQR: 40–57, P = 0.04), experienced longer operative times (median 175 min, IQR: 145–230 min, P = 0.005), and had a higher rate of conversion to open surgery (12%, P = 0.033). For every 1 cm increase in tumor size, the odds ratio for adverse surgical events increased by 1.58. Conclusions: RLA is a safe and feasible procedure for adrenal tumors larger than 6 cm. While intraoperative and postoperative complications are not significantly increased in either group, larger tumors increase surgery times and are more likely to require conversion to open surgery. Therefore, caution and preparedness for potential adverse events are recommended when dealing with larger tumors. A tumor size of 5.3 cm may serve as a guide for risk stratification and surgical planning in large adrenal tumor management.
AB - Introduction: Adrenal tumors are relatively common, and adrenalectomy is the third most common endocrine surgery. Patients with adrenal tumors were categorized into two groups for analysis: those with intermediate (4–6 cm, Group 1) and large (>6 cm, Group 2) tumors undergoing Retroperitoneal Laparoscopic Adrenalectomy (RLA). The primary outcome is to compare the surgical outcomes between these two groups. The secondary outcome involves analyzing the relationship between tumor characteristics and the incidence of adverse events. Methods: Data from 76 patients who underwent RLA for tumors of size ≥4 cm between 2005 and 2022 at a single tertiary referral center were analyzed retrospectively. Variables, including patients' age, hormone function, operation time, conversion to open approach, perioperative complications, and adverse surgical events (blood loss >500 cc, conversion to open approach, and perioperative complications), were assessed. Results: No significant differences were observed between the two groups in terms of functional and histopathologic analysis, gender distribution, functioning factors, perioperative complications, and estimated blood loss. However, patients in Group 2 were younger (median age 50, IQR: 40–57, P = 0.04), experienced longer operative times (median 175 min, IQR: 145–230 min, P = 0.005), and had a higher rate of conversion to open surgery (12%, P = 0.033). For every 1 cm increase in tumor size, the odds ratio for adverse surgical events increased by 1.58. Conclusions: RLA is a safe and feasible procedure for adrenal tumors larger than 6 cm. While intraoperative and postoperative complications are not significantly increased in either group, larger tumors increase surgery times and are more likely to require conversion to open surgery. Therefore, caution and preparedness for potential adverse events are recommended when dealing with larger tumors. A tumor size of 5.3 cm may serve as a guide for risk stratification and surgical planning in large adrenal tumor management.
KW - adrenal tumor
KW - adverse events
KW - outcomes
KW - postoperative complications
KW - retroperitoneal laparoscopic adrenalectomy
KW - tumor size
UR - http://www.scopus.com/inward/record.url?scp=85203010971&partnerID=8YFLogxK
U2 - 10.3389/fsurg.2023.1284093
DO - 10.3389/fsurg.2023.1284093
M3 - Article
AN - SCOPUS:85203010971
SN - 2296-875X
VL - 10
JO - Frontiers in Surgery
JF - Frontiers in Surgery
M1 - 1284093
ER -