Challenging risk factors for right and left laparoscopic adrenalectomy: A single centre experience with 272 cases

Vol. 45 (x): 2019 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2019.0131


ORIGINAL ARTICLE

Kadir Omur Gunseren 1, Mehmet Cagatay Cicek 1, Hakan Vuruskan 1, Yakup Kordan 2, Ismet Yavascaoglu 1
1 Department of Urology, Uludag University, School of Medicine, Nilufer, Bursa, Turkey; 2 Departmet of Urology, Koc University, School of Medicine, Nilufer, Bursa, Turkey

ABSTRACT

Purpose: This study aimed to compare perioperative and postoperative results of right and left laparoscopic adrenalectomy (LA), and to evaluate the impact of challenging factors on these outcomes.

Materials and Methods: A total of 272 patient’s medical records that underwent single side LA between October 2006 and September 2017 were retrospectively reviewed. The patients were divided into 2 groups according to operation side. Moreover, pheochromocytoma, metastatic masses and adrenal lesions >5cm in size were considered to be difficult adrenalectomy cases and the outcomes of these cases were compared between two groups.

Results: 135 patients (49.6%) underwent right LA and 137 patients (50.4%) underwent left LA. Operation time, estimated blood loss (EBL) and hospitalization time were similar between the groups (p=0.415, p=0.242, p=0.741, respectively). Although EBL was higher on the right side than the left (p=0.038) in the fi rst 20 cases, after this learning period has been completed, there was no signifi cant difference between the groups. In patients with pheochromocytoma, metastatic mass and a mass >5cm in size, despite bleeding complications were clinically higher on the right side, this difference was not statistically significant.

Conclusions: During the learning period of LA, EBL is higher on the right side. Due to the greater risk of bleeding complications on the right side even on the hands of experienced surgeons, extra care and preoperative planning are required in patients with pheochromocytoma, metastatic masses and masses >5cm in size.

Keywords: Laparoscopy; Adrenalectomy; Risk Factors

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