Adrenalectomy in Hong Kong: a critical review of adoption of laparoscopic approach

Abstract Background A population-based study on adrenal surgery for treatment of adrenal diseases is still lacking. The aim of the present study is to evaluate the practice and the adoption of laparoscopic adrenalectomy (LA) in a stable population, as well as the potential impact of case volume on o...

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Bibliographic Details
Published in:The American journal of surgery 2007-08, Vol.194 (2), p.153-158
Main Authors: Kwan, Tim Lok, M.B.B.S. (HK), F.R.C.S. (Edin.), Lam, Chi Ming, M.S. (HK), F.R.C.S. (Edin.), Yuen, Albert W.C., M.B.B.S. (HK), F.R.A.C.S, Lo, Chung Yau, M.S. (HK), F.R.C.S. (Edin.)
Format: Article
Language:English
Subjects:
Adrenal Gland Diseases - pathology
Adrenal Gland Diseases - surgery
Adrenalectomy
Adrenalectomy - methods
Adrenalectomy - trends
Adrenalectomy - utilization
Adult
Disease
Female
Hong Kong
Hospitalization
Humans
Laparoscopic approach
Laparoscopy - trends
Laparoscopy - utilization
Length of Stay
Male
Middle Aged
Mortality
Outcome
Population
Population-based study
Practice Patterns, Physicians' - trends
Retrospective Studies
Surgery
Teaching hospitals
Technology Transfer
Treatment Outcome
Tumors
Workload
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Summary:Abstract Background A population-based study on adrenal surgery for treatment of adrenal diseases is still lacking. The aim of the present study is to evaluate the practice and the adoption of laparoscopic adrenalectomy (LA) in a stable population, as well as the potential impact of case volume on outcomes. Methods Patients undergoing elective adrenalectomy (n = 486) from 15 Hong Kong public hospitals over a 6-year period were reviewed. Patients undergoing LA (n = 353) were compared to those undergoing open adrenalectomy (n = 133). Results The overall number of adrenalectomies and the number and proportion of laparoscopic approach increased progressively during this period. The median operating time was similar but the median blood loss (50 mL vs 300 mL, P < .01) was less and the mean hospital stay (4.4 days vs 9.4 days) was shorter for LA. Smaller lesions tended to be selected for LA. There was no correlation between postoperative outcome with respect to length of stay and case volume for LA. Conclusions The adoption of LA in Hong Kong hospitals was propagating progressively. Patients selected for LA had improved outcome although there seemed to be no significant correlation between postoperative outcome and case volume.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2006.11.030