Loading...
Posterior retroperitoneoscopic adrenalectomy: Outcomes and lessons learned from initial 50 cases
Cabalag, Miguel S. Mann, G. Bruce Gorelik, Alexandra Miller, Julie A.
Cabalag, Miguel S.
Mann, G. Bruce
Gorelik, Alexandra
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.
Keywords
adrenalectomy, analgesia, minimally invasive, outcomes, posterior retroperitoneoscopic
Date
2015
Type
Journal article
Journal
ANZ Journal of Surgery
Book
Volume
85
Issue
6
Page Range
478-482
Article Number
ACU Department
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled