Body mass index and postoperative outcomes of patients with laparoscopic adrenalectomy. A single center experience.
EAES Academy. Faur F. 07/05/22; 363150; P195
Dr. Flaviu Ionut Faur
Contributions
Contributions
Abstract
Objectives
Laparoscopic adrenalectomy has become the standard of care for resection of adrenal masses with extremely low morbidity and mortality. This study investigates the difference in outcomes in patients who underwent laparoscopic adrenalectomy, comparing obese with non-obese patients.
Methods:
This is a prospective study between 01.01.2017 - 31.12.2019. Setting: Pius Brinzeu Clinical Hospital Timisoara, Romania that includes 69 laparoscopic adrenalectomies. Selection criteria: Minimally invasive adrenalectomy (tumor size bellow 10 cm). All patients were managed by a constant surgical team, in the General II nd Department of Surgery of the Pius Brinzeu Clinical Hospital Timisoara, Romania. The preoperative workup and postoperative follow-up was performed in over 96% of cases in our department and in the endocrinology department of our hospital. In this article all values are presented as mean±standard deviation for continuous variables, or percentages for categorical variables.
Results
The mean age of the patients population was 53.2±9 years old. The mean diameter of adrenal glands resected was 5.2±3.4 cm with a higher proportion of masses resected were left sided 53.62 %, 46.37 % right sided. The largest percentage of these lesions were adenoma (44.92 %), aldosteronoma (20.28%), pheocromocythoma (13.04 %), angiomyolipoma (17.39 %) and ganglioneuroma (4.3 %). Median operative time for our patient population was 123.5 minutes (range 96-165minutes), while median estimated blood loss (EBL) was 52 ml (range 30-350 ml). The median length of stay (LOS) was 2 days (range 1-5). Adjusting for sex, the final logistic regression model predicting 30-day complications found obese patients were significantly (P=0.036) more likely to have complications compared to non-obese patients. Women were significantly (P=0.042) more likely to have 30-day complication (OR=3.91, 95% CI=1.32 11.47). The final regression model for LOS had no significant predictors. Obesity status was significant in predicting major postoperative complications (n= 8, 19.04 %).
Conclusions:
Laparoscopic adrenalectomy can be performed in non-obese as well in obese patients. Although there is a statistically increase in intraoperative and major postoperative complications for obese patients undergoing laparoscopic adrenalectomy, the clinical significance seems less obvious as it was shown that the laparoscopic approach has fewer complications than open surgery has. These results should rather challenge physicians to optimize obese patients prior to surgical intervention to avoid such complications.
Laparoscopic adrenalectomy has become the standard of care for resection of adrenal masses with extremely low morbidity and mortality. This study investigates the difference in outcomes in patients who underwent laparoscopic adrenalectomy, comparing obese with non-obese patients.
Methods:
This is a prospective study between 01.01.2017 - 31.12.2019. Setting: Pius Brinzeu Clinical Hospital Timisoara, Romania that includes 69 laparoscopic adrenalectomies. Selection criteria: Minimally invasive adrenalectomy (tumor size bellow 10 cm). All patients were managed by a constant surgical team, in the General II nd Department of Surgery of the Pius Brinzeu Clinical Hospital Timisoara, Romania. The preoperative workup and postoperative follow-up was performed in over 96% of cases in our department and in the endocrinology department of our hospital. In this article all values are presented as mean±standard deviation for continuous variables, or percentages for categorical variables.
Results
The mean age of the patients population was 53.2±9 years old. The mean diameter of adrenal glands resected was 5.2±3.4 cm with a higher proportion of masses resected were left sided 53.62 %, 46.37 % right sided. The largest percentage of these lesions were adenoma (44.92 %), aldosteronoma (20.28%), pheocromocythoma (13.04 %), angiomyolipoma (17.39 %) and ganglioneuroma (4.3 %). Median operative time for our patient population was 123.5 minutes (range 96-165minutes), while median estimated blood loss (EBL) was 52 ml (range 30-350 ml). The median length of stay (LOS) was 2 days (range 1-5). Adjusting for sex, the final logistic regression model predicting 30-day complications found obese patients were significantly (P=0.036) more likely to have complications compared to non-obese patients. Women were significantly (P=0.042) more likely to have 30-day complication (OR=3.91, 95% CI=1.32 11.47). The final regression model for LOS had no significant predictors. Obesity status was significant in predicting major postoperative complications (n= 8, 19.04 %).
Conclusions:
Laparoscopic adrenalectomy can be performed in non-obese as well in obese patients. Although there is a statistically increase in intraoperative and major postoperative complications for obese patients undergoing laparoscopic adrenalectomy, the clinical significance seems less obvious as it was shown that the laparoscopic approach has fewer complications than open surgery has. These results should rather challenge physicians to optimize obese patients prior to surgical intervention to avoid such complications.
Objectives
Laparoscopic adrenalectomy has become the standard of care for resection of adrenal masses with extremely low morbidity and mortality. This study investigates the difference in outcomes in patients who underwent laparoscopic adrenalectomy, comparing obese with non-obese patients.
Methods:
This is a prospective study between 01.01.2017 - 31.12.2019. Setting: Pius Brinzeu Clinical Hospital Timisoara, Romania that includes 69 laparoscopic adrenalectomies. Selection criteria: Minimally invasive adrenalectomy (tumor size bellow 10 cm). All patients were managed by a constant surgical team, in the General II nd Department of Surgery of the Pius Brinzeu Clinical Hospital Timisoara, Romania. The preoperative workup and postoperative follow-up was performed in over 96% of cases in our department and in the endocrinology department of our hospital. In this article all values are presented as mean±standard deviation for continuous variables, or percentages for categorical variables.
Results
The mean age of the patients population was 53.2±9 years old. The mean diameter of adrenal glands resected was 5.2±3.4 cm with a higher proportion of masses resected were left sided 53.62 %, 46.37 % right sided. The largest percentage of these lesions were adenoma (44.92 %), aldosteronoma (20.28%), pheocromocythoma (13.04 %), angiomyolipoma (17.39 %) and ganglioneuroma (4.3 %). Median operative time for our patient population was 123.5 minutes (range 96-165minutes), while median estimated blood loss (EBL) was 52 ml (range 30-350 ml). The median length of stay (LOS) was 2 days (range 1-5). Adjusting for sex, the final logistic regression model predicting 30-day complications found obese patients were significantly (P=0.036) more likely to have complications compared to non-obese patients. Women were significantly (P=0.042) more likely to have 30-day complication (OR=3.91, 95% CI=1.32 11.47). The final regression model for LOS had no significant predictors. Obesity status was significant in predicting major postoperative complications (n= 8, 19.04 %).
Conclusions:
Laparoscopic adrenalectomy can be performed in non-obese as well in obese patients. Although there is a statistically increase in intraoperative and major postoperative complications for obese patients undergoing laparoscopic adrenalectomy, the clinical significance seems less obvious as it was shown that the laparoscopic approach has fewer complications than open surgery has. These results should rather challenge physicians to optimize obese patients prior to surgical intervention to avoid such complications.
Laparoscopic adrenalectomy has become the standard of care for resection of adrenal masses with extremely low morbidity and mortality. This study investigates the difference in outcomes in patients who underwent laparoscopic adrenalectomy, comparing obese with non-obese patients.
Methods:
This is a prospective study between 01.01.2017 - 31.12.2019. Setting: Pius Brinzeu Clinical Hospital Timisoara, Romania that includes 69 laparoscopic adrenalectomies. Selection criteria: Minimally invasive adrenalectomy (tumor size bellow 10 cm). All patients were managed by a constant surgical team, in the General II nd Department of Surgery of the Pius Brinzeu Clinical Hospital Timisoara, Romania. The preoperative workup and postoperative follow-up was performed in over 96% of cases in our department and in the endocrinology department of our hospital. In this article all values are presented as mean±standard deviation for continuous variables, or percentages for categorical variables.
Results
The mean age of the patients population was 53.2±9 years old. The mean diameter of adrenal glands resected was 5.2±3.4 cm with a higher proportion of masses resected were left sided 53.62 %, 46.37 % right sided. The largest percentage of these lesions were adenoma (44.92 %), aldosteronoma (20.28%), pheocromocythoma (13.04 %), angiomyolipoma (17.39 %) and ganglioneuroma (4.3 %). Median operative time for our patient population was 123.5 minutes (range 96-165minutes), while median estimated blood loss (EBL) was 52 ml (range 30-350 ml). The median length of stay (LOS) was 2 days (range 1-5). Adjusting for sex, the final logistic regression model predicting 30-day complications found obese patients were significantly (P=0.036) more likely to have complications compared to non-obese patients. Women were significantly (P=0.042) more likely to have 30-day complication (OR=3.91, 95% CI=1.32 11.47). The final regression model for LOS had no significant predictors. Obesity status was significant in predicting major postoperative complications (n= 8, 19.04 %).
Conclusions:
Laparoscopic adrenalectomy can be performed in non-obese as well in obese patients. Although there is a statistically increase in intraoperative and major postoperative complications for obese patients undergoing laparoscopic adrenalectomy, the clinical significance seems less obvious as it was shown that the laparoscopic approach has fewer complications than open surgery has. These results should rather challenge physicians to optimize obese patients prior to surgical intervention to avoid such complications.
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