Clinical outcomes and learning curve of a laparoscopic adrenalectomy in 103 consecutive cases at a single institute
- 1 June 2006
- journal article
- Published by Wiley in International Journal of Urology
- Vol. 13 (6), 671-676
- https://doi.org/10.1111/j.1442-2042.2006.01383.x
Abstract
We examined the clinical outcomes and the learning curve for a laparoscopic adrenalectomy (LA) in 103 consecutive cases performed by three surgeons at our institute, according to the type of adrenal disorder. One hundred and three patients with adrenal tumors, including 38 cases of primary aldosteronism, 33 cases of Cushing syndrome (including preclinical Cushing syndrome), 15 cases of pheochromocytoma, and nine cases of non-functioning adenoma were evaluated, while focusing on the approaches, intraoperative and postoperative data, and the learning curve of LA, according the type of adrenal disorder. There was no significant difference in the operation time, estimated blood loss, incidence of conversion to open surgery and blood transfusion, or postoperative recovery among the patients treated by LA for aldosteronoma, Cushing adenoma, pheochromocytoma, and non-functioning adenoma. In the cases of aldosteronoma and Cushing adenoma, the learning curve for the operation time and blood loss in each operator tended to decrease as the number of operations increased. On the other hand, in the cases treated by LA for pheochromocytoma, no trends in either the operation time or blood loss were observed. However, there has been neither any conversion to open surgery nor blood transfusion in cases treated by LA since 1998 (our 42nd case), even after the changes in the operators. Our results clearly indicate that LA is becoming safer than before, probably due to improvements in the technique, education, and training of surgeons, in addition to the increased number of cases now treated by LA.Keywords
This publication has 22 references indexed in Scilit:
- EXPERIENCE WITH RETROPERITONEAL LAPAROSCOPIC ADRENALECTOMY IN 115 PROCEDURESJournal of Urology, 2001
- Transperitoneal Laparoscopic Adrenalectomy: Experience in 72 ProceduresJournal of Endourology, 2001
- Laparoscopic Adrenalectomy for Pheochromocytoma: Comparison with Open Adrenalectomy and Comparison of Laparoscopic Surgery for Pheochromocytoma versus Other Adrenal TumorsJournal of Endourology, 2000
- Transperitoneal Laparoscopic Adrenalectomy: Experience in 100 PatientsJournal of Endourology, 1997
- Laparoscopic AdrenalectomyAnnals of Surgery, 1997
- Laparoscopic Adrenalectomy via the Retroperitoneal Approach: First Five CasesJournal of Endourology, 1996
- Laparoscopic Adrenalectomy: Review of 14 Cases and Comparison with Open AdrenalectomyJournal of Endourology, 1995
- Laparoscopic Approach to the Adrenal TumorsJournal of Laparoendoscopic Surgery, 1993
- Laparoscopic Adrenalectomy for Primary Aldosteronism: A New Operative MethodJournal of Laparoendoscopic Surgery, 1993
- Laparoscopic AdrenalectomyJournal of Laparoendoscopic Surgery, 1993