Retroperitoneal laparoscopic adrenalectomy for large adrenal tumors—analysis of tumor size and adverse events: a retrospective single-center study
IntroductionAdrenal 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 La...
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1284093/full |
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| author | I-Chen Tsai Yu-Che Hsieh Yu-Che Hsieh Wen-Hsin Tseng Chien-Liang Liu Chien-Liang Liu Chung-Han Ho Chung-Han Ho Chien-Feng Li Allen W. Chiu Steven K. Huang |
| author_facet | I-Chen Tsai Yu-Che Hsieh Yu-Che Hsieh Wen-Hsin Tseng Chien-Liang Liu Chien-Liang Liu Chung-Han Ho Chung-Han Ho Chien-Feng Li Allen W. Chiu Steven K. Huang |
| author_sort | I-Chen Tsai |
| collection | DOAJ |
| description | IntroductionAdrenal 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.MethodsData 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.ResultsNo 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.ConclusionsRLA 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. |
| first_indexed | 2024-03-08T16:51:25Z |
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| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-08T16:51:25Z |
| publishDate | 2024-01-01 |
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| series | Frontiers in Surgery |
| spelling | doaj.art-d04cbd16cc8240b593744786bdfd55802024-01-05T04:36:22ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2024-01-011010.3389/fsurg.2023.12840931284093Retroperitoneal laparoscopic adrenalectomy for large adrenal tumors—analysis of tumor size and adverse events: a retrospective single-center studyI-Chen Tsai0Yu-Che Hsieh1Yu-Che Hsieh2Wen-Hsin Tseng3Chien-Liang Liu4Chien-Liang Liu5Chung-Han Ho6Chung-Han Ho7Chien-Feng Li8Allen W. Chiu9Steven K. Huang10Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, TaiwanDivision of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, TaiwanThe Doctoral Program of Clinical and Experimental Medicine, National Sun Yat-Sen University, Kaohsiung, TaiwanDivision of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, TaiwanDivision of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, TaiwanDivision of Uro-Oncology, Department of Surgery, Chi Mei Medical Center, Tainan, TaiwanDepartment of Medical Research, Chi Mei Medical Center, Tainan, TaiwanDepartment of Information Management, Southern Taiwan University of Science and Technology, Tainan, TaiwanDepartment of Pathology, Chi Mei Medical Center, Tainan, TaiwanDepartment of Urology, Mackay Memorial Hospital, Taipei, TaiwanDivision of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, TaiwanIntroductionAdrenal 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.MethodsData 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.ResultsNo 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.ConclusionsRLA 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.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1284093/fulladrenal tumoradverse eventsoutcomespostoperative complicationsretroperitoneal laparoscopic adrenalectomytumor size |
| spellingShingle | I-Chen Tsai Yu-Che Hsieh Yu-Che Hsieh Wen-Hsin Tseng Chien-Liang Liu Chien-Liang Liu Chung-Han Ho Chung-Han Ho Chien-Feng Li Allen W. Chiu Steven K. Huang Retroperitoneal laparoscopic adrenalectomy for large adrenal tumors—analysis of tumor size and adverse events: a retrospective single-center study Frontiers in Surgery adrenal tumor adverse events outcomes postoperative complications retroperitoneal laparoscopic adrenalectomy tumor size |
| title | Retroperitoneal laparoscopic adrenalectomy for large adrenal tumors—analysis of tumor size and adverse events: a retrospective single-center study |
| title_full | Retroperitoneal laparoscopic adrenalectomy for large adrenal tumors—analysis of tumor size and adverse events: a retrospective single-center study |
| title_fullStr | Retroperitoneal laparoscopic adrenalectomy for large adrenal tumors—analysis of tumor size and adverse events: a retrospective single-center study |
| title_full_unstemmed | Retroperitoneal laparoscopic adrenalectomy for large adrenal tumors—analysis of tumor size and adverse events: a retrospective single-center study |
| title_short | Retroperitoneal laparoscopic adrenalectomy for large adrenal tumors—analysis of tumor size and adverse events: a retrospective single-center study |
| title_sort | retroperitoneal laparoscopic adrenalectomy for large adrenal tumors analysis of tumor size and adverse events a retrospective single center study |
| topic | adrenal tumor adverse events outcomes postoperative complications retroperitoneal laparoscopic adrenalectomy tumor size |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1284093/full |
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