Impact of novel techniques on minimally invasive adrenal surgery: trends and outcomes from a contemporary international large series in urology

Objective To evaluate contemporary international trends in the implementation of minimally invasive adrenalectomy and to assess contemporary outcomes of different minimally invasive techniques performed at urologic centers worldwide. Methods A retrospective multinational multicenter study of patient...

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Bibliographic Details
Published in:World journal of urology 2016-10, Vol.34 (10), p.1473-1479
Main Authors: Pavan, Nicola, Autorino, Riccardo, Lee, Hak, Porpiglia, Francesco, Sun, Yinghao, Greco, Francesco, Jeff Chueh, S., Han, Deok Hyun, Cindolo, Luca, Ferro, Matteo, Chen, Xiang, Branco, Anibal, Fornara, Paolo, Liao, Chun-Hou, Miyajima, Akira, Kyriazis, Iason, Puglisi, Marco, Fiori, Cristian, Yang, Bo, Fei, Guo, Altieri, Vincenzo, Jeong, Byong Chang, Berardinelli, Francesco, Schips, Luigi, De Cobelli, Ottavio, Chen, Zhi, Haber, Georges-Pascal, He, Yao, Oya, Mototsugu, Liatsikos, Evangelos, Brandao, Luis, Challacombe, Benjamin, Kaouk, Jihad, Darweesh, Ithaar
Format: Article
Language:English
Subjects:
Adrenal Gland Diseases - surgery
Adrenalectomy - methods
Adrenalectomy - trends
Female
Follow-Up Studies
Humans
International Cooperation
Laparoscopy - methods
Male
Medicine
Medicine & Public Health
Middle Aged
Nephrology
Oncology
Original Article
Retrospective Studies
Robotics - methods
Robotics - trends
Time Factors
Treatment Outcome
Urology
Urology - trends
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Summary:Objective To evaluate contemporary international trends in the implementation of minimally invasive adrenalectomy and to assess contemporary outcomes of different minimally invasive techniques performed at urologic centers worldwide. Methods A retrospective multinational multicenter study of patients who underwent minimally invasive adrenalectomy from 2008 to 2013 at 14 urology institutions worldwide was included in the analysis. Cases were categorized based on the minimally invasive adrenalectomy technique: conventional laparoscopy (CL), robot-assisted laparoscopy (RAL), laparoendoscopic single-site surgery (LESS), and mini-laparoscopy (ML). The rates of the four treatment modalities were determined according to the year of surgery, and a regression analysis was performed for trends in all surgical modalities. Results Overall, a total of 737 adrenalectomies were performed across participating institutions and included in this analysis: 337 CL (46 % of cases), 57 ML (8 %), 263 LESS (36 %), and 80 RA (11 %). Overall, 204 (28 %) operations were performed with a retroperitoneal approach. The overall number of adrenalectomies increased from 2008 to 2013 ( p  = 0.05). A transperitoneal approach was preferred in all but the ML group ( p  
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-016-1791-9