Posterior retroperitoneoscopic adrenalectomy: Outcomes and lessons learned from initial 50 cases

Journal article


Cabalag, Miguel S., Mann, G. Bruce, Gorelik, Alexandra and Miller, Julie A.. (2015) Posterior retroperitoneoscopic adrenalectomy: Outcomes and lessons learned from initial 50 cases. ANZ Journal of Surgery. 85(6), pp. 478 - 482. https://doi.org/10.1111/ans.12508
AuthorsCabalag, Miguel S., Mann, G. Bruce, Gorelik, Alexandra and Miller, Julie A.
Abstract

Background: Posterior retroperitoneoscopic adrenalectomy (PRA) is an alternative approach to minimally invasive adrenalectomy, potentially offering less pain and faster recovery compared with laparoscopic transperitoneal adrenalectomy (LA). The authors have recently changed from LA to PRA in suitable patients and audited their first 50 cases. Methods Data were prospectively collected for 50 consecutive PRAs performed by the same surgeon. Patient demographics, tumour characteristics, analgesia use, operative and preparation time, length of stay, and complications were recorded. Results: Fifty adrenalectomies were performed in 49 patients. The median (range) age was 58.5 years (30–83) and the majority of patients were female (n = 33, 66.0%). The median (interquartile range (IQR)) preparation time was 35.5 (28.5–50.0) and median operation time was 70.5 (54–85) min, which decreased during the study period. After a learning curve of 15 cases, median operative time reached 61 min. PRA patients required minimal post‐operative analgesia, with a median (IQR) of 0 (0–5) mg of intravenous morphine equivalent used. The median (IQR) length of stay was 1 (1–1) day, with 8 (16.0%) same‐day discharges. There were four complications: one blood pressure lability from a phaeochromocytoma, one reintubation, one self‐limited bleed and one temporary subcostal neuropraxia. There were no conversions to open surgery or deaths. Conclusion: Our results support previously published findings that PRA is a safe procedure, with a relatively short learning curve, resulting in minimal post‐operative analgesia use and short length of hospital stay.

Keywordsadrenalectomy; analgesia; minimally invasive; outcomes; posterior retroperitoneoscopic
Year2015
JournalANZ Journal of Surgery
Journal citation85 (6), pp. 478 - 482
PublisherWiley-Blackwell
ISSN1445-1433
Digital Object Identifier (DOI)https://doi.org/10.1111/ans.12508
Scopus EID2-s2.0-84930178754
Page range478 - 482
Research GroupSchool of Philosophy
Publisher's version
File Access Level
Controlled
Place of publicationAustralia
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Lin, Jonathan, Moore, David, Hockey, Brad, Di Lernia, Rachel, Gorelik, Alexandra, Liew, Danny and Nicoll, Amanda J.. (2014) Drug-induced hepatotoxicity: Incidence of abnormal liver function tests consistent with volatile anaesthetic hepatitis in trauma patients. Liver International. 34(4), pp. 576 - 582. https://doi.org/10.1111/liv.12278
Predictors of health care use among patients with or at high risk of atherothrombotic disease: Two-year follow-up data
Ademi, Zanfina, Liew, Danny, Gorelik, Alexandra, Bohensky, Megan A., Zomer, Ella, Hollingsworth, Bruce, Steg, Gabriel, Bhatt, Deepak L. and Reid, Christopher M.. (2014) Predictors of health care use among patients with or at high risk of atherothrombotic disease: Two-year follow-up data. International Journal of Cardiology. 175(1), pp. 72 - 77. https://doi.org/10.1016/j.ijcard.2014.04.230
Long term follow-up after aortic valve replacement (Ross Procedure): Echocardiographic determinants of ventricular recovery
Wilson, William M., Grigg, Leeanne E., Gorelik, Alexandra and Skillington, Peter. (2014) Long term follow-up after aortic valve replacement (Ross Procedure): Echocardiographic determinants of ventricular recovery. Heart Lung and Circulation. 23(2), pp. 132 - 143. https://doi.org/10.1016/j.hlc.2013.07.008
Geographical variation in incidence of knee arthroscopy for patients with osteoarthritis: A population-based analysis of Victorian hospital separations data
Bohensky, Megan A., Barker, Anna, Morello, Renata Teresa, De Steiger, Richard N., Gorelik, Alexandra and Brand, Caroline A.. (2014) Geographical variation in incidence of knee arthroscopy for patients with osteoarthritis: A population-based analysis of Victorian hospital separations data. Internal Medicine Journal. 44(6), pp. 537 - 545. https://doi.org/10.1111/imj.12438
Thyroid surgery and anticoagulation: Survey of practice of endocrine surgeons in Australia
Verma, Kunal Pradip, Gorelik, Alexandra and Miller, Julie A.. (2013) Thyroid surgery and anticoagulation: Survey of practice of endocrine surgeons in Australia. World Journal of Endocrine Surgery. 5(1), pp. 6 - 11. https://doi.org/10.5005/jp-journals-10002-1115
Primary angiitis of the central nervous system: Experience of a Victorian tertiary-referral hospital
Oon, S., Roberts, Carol, Gorelik, Alexandra, Wicks, I. and Brand, Caroline A.. (2013) Primary angiitis of the central nervous system: Experience of a Victorian tertiary-referral hospital. Internal Medicine Journal. 43(6), pp. 685 - 692. https://doi.org/10.1111/imj.12038
Outcomes and excess costs among patients with cardiovascular disease
Ademi, Zanfina, Liew, Danny, Zomer, Ella, Gorelik, Alexandra, Hollingsworth, Bruce, Steg, Philippe Gabriel, Bhatt, Deepak L. and Reid, Christopher M.. (2013) Outcomes and excess costs among patients with cardiovascular disease. Heart Lung and Circulation. 22(9), pp. 724 - 730. https://doi.org/10.1016/j.hlc.2013.02.002
Epidemiology of hepatitis B-associated hepatocellular carcinoma in Victoria
Sinclair, M., Roberts, S., Kemp, W., Knight, V., Dev, A., Gow, P., Philpott, H., Kronborg, Ian, Arachchi, Niranjan J., Bell, Sally J., Lim, Lucy, Gorelik, Alexandra and Nicoll, Amanda J.. (2013) Epidemiology of hepatitis B-associated hepatocellular carcinoma in Victoria. Internal Medicine Journal. 43(5), pp. 501 - 506. https://doi.org/10.1111/imj.12068
Who, why and when: Stroke care unit patients seen by a palliative care service within a large metropolitan teaching hospital
Eastman, Peter, McCarthy, Gillian, Brand, Caroline A., Weir, Louise, Gorelik, Alexandra and Le, Brian. (2013) Who, why and when: Stroke care unit patients seen by a palliative care service within a large metropolitan teaching hospital. BMJ Supportive and Palliative Care. 3(1), pp. 77 - 83. https://doi.org/10.1136/bmjspcare-2012-000331