Predictors of complication after adrenalectomy

ABSTRACT Purpose: To investigate risk factors for complications in patients undergoing adrenalectomy. Materials and Methods: A retrospective search of our institutional database was performed of patients who underwent adrenalectomy, between 2014 and 2018. Clinical parameters and adrenal disorder c...

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Main Authors: Victor Srougi, João A. B. Barbosa, Isaac Massaud, Isadora P. Cavalcante, Fabio Y. Tanno, Madson Q. Almeida, Miguel Srougi, Maria C. Fragoso, José L. Chambô
Format: Article
Language:English
Published: Sociedade Brasileira de Urologia
Series:International Brazilian Journal of Urology
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382019000300514&lng=en&tlng=en
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author Victor Srougi
João A. B. Barbosa
Isaac Massaud
Isadora P. Cavalcante
Fabio Y. Tanno
Madson Q. Almeida
Miguel Srougi
Maria C. Fragoso
José L. Chambô
author_facet Victor Srougi
João A. B. Barbosa
Isaac Massaud
Isadora P. Cavalcante
Fabio Y. Tanno
Madson Q. Almeida
Miguel Srougi
Maria C. Fragoso
José L. Chambô
author_sort Victor Srougi
collection DOAJ
description ABSTRACT Purpose: To investigate risk factors for complications in patients undergoing adrenalectomy. Materials and Methods: A retrospective search of our institutional database was performed of patients who underwent adrenalectomy, between 2014 and 2018. Clinical parameters and adrenal disorder characteristics were assessed and correlated to intra and post-operative course. Complications were analyzed within 30-days after surgery. A logistic regression was performed in order to identify independent predictors of morbidity in patients after adrenalectomy. Results: The files of 154 patients were reviewed. Median age and Body Mass Index (BMI) were 52-years and 27.8kg/m2, respectively. Mean tumor size was 4.9±4cm. Median surgery duration and estimated blood loss were 140min and 50mL, respectively. There were six conversions to open surgery. Minor and major post-operative complications occurred in 17.5% and 8.4% of the patients. Intra-operative complications occurred in 26.6% of the patients. Four patients died. Mean hospitalization duration was 4-days (Interquartile Range: 3-8). Patients age (p=0.004), comorbidities (p=0.003) and pathological diagnosis (p=0.003) were independent predictors of post-operative complications. Tumor size (p<0.001) and BMI (p=0.009) were independent predictors of intra-operative complications. Pathological diagnosis (p<0.001) and Charlson score (p=0.013) were independent predictors of death. Conclusion: Diligent care is needed with older patients, with multiple comorbidities and harboring unfavorable adrenal disorders (adrenocortical carcinoma and pheocromocytoma), who have greater risk of post-operative complications. Patients with elevated BMI and larger tumors have higher risk of intra, but not of post-operative complications.
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spelling doaj.art-799147d77d334404be35707d73ae1e8a2022-12-21T17:31:29ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-611945351452210.1590/s1677-5538.ibju.2018.0482S1677-55382019000300514Predictors of complication after adrenalectomyVictor SrougiJoão A. B. BarbosaIsaac MassaudIsadora P. CavalcanteFabio Y. TannoMadson Q. AlmeidaMiguel SrougiMaria C. FragosoJosé L. ChambôABSTRACT Purpose: To investigate risk factors for complications in patients undergoing adrenalectomy. Materials and Methods: A retrospective search of our institutional database was performed of patients who underwent adrenalectomy, between 2014 and 2018. Clinical parameters and adrenal disorder characteristics were assessed and correlated to intra and post-operative course. Complications were analyzed within 30-days after surgery. A logistic regression was performed in order to identify independent predictors of morbidity in patients after adrenalectomy. Results: The files of 154 patients were reviewed. Median age and Body Mass Index (BMI) were 52-years and 27.8kg/m2, respectively. Mean tumor size was 4.9±4cm. Median surgery duration and estimated blood loss were 140min and 50mL, respectively. There were six conversions to open surgery. Minor and major post-operative complications occurred in 17.5% and 8.4% of the patients. Intra-operative complications occurred in 26.6% of the patients. Four patients died. Mean hospitalization duration was 4-days (Interquartile Range: 3-8). Patients age (p=0.004), comorbidities (p=0.003) and pathological diagnosis (p=0.003) were independent predictors of post-operative complications. Tumor size (p<0.001) and BMI (p=0.009) were independent predictors of intra-operative complications. Pathological diagnosis (p<0.001) and Charlson score (p=0.013) were independent predictors of death. Conclusion: Diligent care is needed with older patients, with multiple comorbidities and harboring unfavorable adrenal disorders (adrenocortical carcinoma and pheocromocytoma), who have greater risk of post-operative complications. Patients with elevated BMI and larger tumors have higher risk of intra, but not of post-operative complications.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382019000300514&lng=en&tlng=enAdrenalectomyMorbidityPathology
spellingShingle Victor Srougi
João A. B. Barbosa
Isaac Massaud
Isadora P. Cavalcante
Fabio Y. Tanno
Madson Q. Almeida
Miguel Srougi
Maria C. Fragoso
José L. Chambô
Predictors of complication after adrenalectomy
International Brazilian Journal of Urology
Adrenalectomy
Morbidity
Pathology
title Predictors of complication after adrenalectomy
title_full Predictors of complication after adrenalectomy
title_fullStr Predictors of complication after adrenalectomy
title_full_unstemmed Predictors of complication after adrenalectomy
title_short Predictors of complication after adrenalectomy
title_sort predictors of complication after adrenalectomy
topic Adrenalectomy
Morbidity
Pathology
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382019000300514&lng=en&tlng=en
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