Indications for laparoscopic adrenalectomy as a determinant of the perioperative and postoperative course: a retrospective, single-centre cohort study

Łukasz Niedziela; Emilia Niedziela; Mateusz Obarzanowski; Paweł Orłowski; Marcin Kosowski; Aldona Kowalska; Stanisław Góźdź; Jarosław Jaskulski

doi:10.5114/ms.2023.134081

eISSN: 2300-6722
ISSN: 1899-1874

Medical Studies/Studia Medyczne

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4/2023
vol. 39

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abstract:

Original paper

Indications for laparoscopic adrenalectomy as a determinant of the perioperative and postoperative course: a retrospective, single-centre cohort study

Łukasz Niedziela

^{1, 2}

,

Emilia Niedziela

^{2, 3}

,

Mateusz Obarzanowski

^{1, 2}

,

Paweł Orłowski

^{1, 2}

,

Marcin Kosowski

^{1, 2}

,

Aldona Kowalska

^{2, 3}

,

Stanisław Góźdź

^{3, 4}

,

Jarosław Jaskulski

^{1, 2}

Department of Urology, Holycross Cancer Centre, Kielce, Poland
Collegium Medicum, Jan Kochanowski University, Kielce, Poland
Department of Endocrinology, Holycross Cancer Centre, Kielce, Poland
Department of Clinical Oncology, Holycross Cancer Centre, Kielce, Poland

Medical Studies/Studia Medyczne 2023; 39 (4): 311-318

DOI: https://doi.org/10.5114/ms.2023.134081

Online publish date: 2023/12/30

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AMA

Niedziela Ł, Niedziela E, Obarzanowski M, et al. Indications for laparoscopic adrenalectomy as a determinant of the perioperative and postoperative course: a retrospective, single-centre cohort study. Medical Studies/Studia Medyczne. 2023;39(4):311-318. doi:10.5114/ms.2023.134081.

APA

Niedziela, Ł., Niedziela, E., Obarzanowski, M., Orłowski, P., Kosowski, M.,  & Kowalska, A. et al. (2023). Indications for laparoscopic adrenalectomy as a determinant of the perioperative and postoperative course: a retrospective, single-centre cohort study. Medical Studies/Studia Medyczne, 39(4), 311-318. https://doi.org/10.5114/ms.2023.134081

Chicago

Niedziela, Łukasz, Emilia Niedziela, Mateusz Obarzanowski, Paweł Orłowski, Marcin Kosowski, Aldona Kowalska,  and Stanisław Góźdź et al. 2023. "Indications for laparoscopic adrenalectomy as a determinant of the perioperative and postoperative course: a retrospective, single-centre cohort study". Medical Studies/Studia Medyczne 39 (4): 311-318. doi:10.5114/ms.2023.134081.

Harvard

Niedziela, Ł., Niedziela, E., Obarzanowski, M., Orłowski, P., Kosowski, M., Kowalska, A., Góźdź, S.,  and Jaskulski, J. (2023). Indications for laparoscopic adrenalectomy as a determinant of the perioperative and postoperative course: a retrospective, single-centre cohort study. Medical Studies/Studia Medyczne, 39(4), pp.311-318. https://doi.org/10.5114/ms.2023.134081

MLA

Niedziela, Łukasz et al. "Indications for laparoscopic adrenalectomy as a determinant of the perioperative and postoperative course: a retrospective, single-centre cohort study." Medical Studies/Studia Medyczne, vol. 39, no. 4, 2023, pp. 311-318. doi:10.5114/ms.2023.134081.

Vancouver

Niedziela Ł, Niedziela E, Obarzanowski M, Orłowski P, Kosowski M, Kowalska A et al. Indications for laparoscopic adrenalectomy as a determinant of the perioperative and postoperative course: a retrospective, single-centre cohort study. Medical Studies/Studia Medyczne. 2023;39(4):311-318. doi:10.5114/ms.2023.134081.

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Introduction
Laparoscopic adrenalectomy (LA) is a widely used method for the surgical management of adrenal tumours.

Aim of the research
To compare the perioperative and postoperative course in patients with adrenal lesions based on indications for LA.

Material and methods
We conducted a retrospective, single-centre data analysis of patients undergoing LA between January 2015 and December 2021. The patients were divided into 4 cohorts, depending on endocrine and oncological indications: (1) hormonally active tumours, (2) non-functioning tumours measuring < 40 mm with suspected radiologic features, (3) non-functioning tumours measuring ≥ 40 mm, and (4) metastases. We established our outcomes on clinical characteristics (age, sex, BMI, Charlson Comorbidity Index (CCI), ASA score, smoking history), perioperative data (side, operation time, blood loss, intraoperative complications, conversion to open surgery, time of drainage, and duration of hospital stay), and postoperative data (histopathological report, 30-day complication rate).

Results
A total of 140 patients were included in the study. Comparative analysis of the groups showed differences in ASA score, smoking history, and CCI. The mean operating time was 112 min, and it was significantly longer in the group of patients with adrenal metastases (149 min, p = 0.002). Intraoperative complications were observed in 5 (3.6%) patients, conversion to open surgery was performed 3 times (2.1%). No life-threatening complications were observed in the postoperative period.

Conclusions
LA is a safe method of surgical treatment of adrenal tumours. Removal of adrenal metastases is an advanced laparoscopic procedure that requires an experienced surgeon. The course of treatment depends on the qualification and preparation of patients for the procedure by a multidisciplinary team.

keywords:

Indications for laparoscopic adrenalectomy as a determinant of the perioperative and postoperative course: a retrospective, single-centre cohort study

Łukasz Niedziela 1, 2 , Emilia Niedziela 2, 3 , Mateusz Obarzanowski 1, 2 , Paweł Orłowski 1, 2 , Marcin Kosowski 1, 2 , Aldona Kowalska 2, 3 , Stanisław Góźdź 3, 4 , Jarosław Jaskulski 1, 2

adrenal gland neoplasms, adrenalectomy, laparoscopy

Łukasz Niedziela

^{1, 2}

,

Emilia Niedziela

^{2, 3}

,

Mateusz Obarzanowski

^{1, 2}

,

Paweł Orłowski

^{1, 2}

,

Marcin Kosowski

^{1, 2}

,

Aldona Kowalska

^{2, 3}

,

Stanisław Góźdź

^{3, 4}

,

Jarosław Jaskulski

^{1, 2}