An update of posterior retroperitoneoscopic adrenalectomy – Case series

•Posterior retroperitoneoscopic adrenalectomy (PRA) has advantages over transperitoneal approach.•Operative time and in-hospital days are influenced by surgeon’s experience.•Conversion rate, morbidity and mortality are stable with experience.•A fast-operative time may justify the low morbidity.•PRA...

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Published in:International journal of surgery case reports 2020-01, Vol.71, p.120-125
Main Authors: Costa Almeida, Carlos E., Caroço, Teresa, Silva, Marta A., Baião, José M., Costa, Ana, Albano, Miguel N., Louro, João M., Carvalho, Luis F.
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Language:English
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Adrenal
Endocrine
Minimal invasive surgery
Posterior retroperitoneoscopic adrenalectomy
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container_title International journal of surgery case reports
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creator Costa Almeida, Carlos E.
Caroço, Teresa
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Carvalho, Luis F.
description •Posterior retroperitoneoscopic adrenalectomy (PRA) has advantages over transperitoneal approach.•Operative time and in-hospital days are influenced by surgeon’s experience.•Conversion rate, morbidity and mortality are stable with experience.•A fast-operative time may justify the low morbidity.•PRA has a small learning curve, is feasible and safe. Posterior retroperitoneoscopic adrenalectomy (PRA) has advantages over transperitoneal approach. A second group of 10 patients is analyzed and compared with the first 10 procedures. Conclusions on feasibility, safety and learning curve are taken. A retrospective analysis of a second group of 10 patients submitted to PRA was conducted. All patients with functioning and non-functioning adrenal tumors
doi_str_mv 10.1016/j.ijscr.2020.04.101
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Posterior retroperitoneoscopic adrenalectomy (PRA) has advantages over transperitoneal approach. A second group of 10 patients is analyzed and compared with the first 10 procedures. Conclusions on feasibility, safety and learning curve are taken. A retrospective analysis of a second group of 10 patients submitted to PRA was conducted. All patients with functioning and non-functioning adrenal tumors &lt;6–8 cm and without features of malignancy were included. A comparison with the previous 10 cases was conducted, and the results of all 20 cases were compared with other surgeons. Pre-operative diagnoses: Conn’s syndrome – 8 (80%); Pheochromocytoma – 1 (10%); Non-functioning tumor (≥ 4 cm) – 1 (10%). Mean size of adrenal tumors was 2,9 cm. Mean operative time for first group was 46,7 min and 31,1 min for the second (p = 0,036). Postoperative in-hospital days decreased in the second group (p = 0,01). Conversion rate was equal (10%). Morbidity and mortality were similar. Comparing the evolution of operative time in both groups, a constant and faster operative time was noted for the second group and a decreasing linear tendency was noted as more cases were being performed. Postoperative in-hospital days lowered in the second group, because with experience we started discharging patients earlier. Outcomes are stable between both groups. Our results match other authors data. These results are consistent with our first report and support the small learning curve for PRA, which is technically feasible and safe. Operative time and in-hospital days are influenced by surgeon’s experience. 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subjects Adrenal
Endocrine
Minimal invasive surgery
Posterior retroperitoneoscopic adrenalectomy
title An update of posterior retroperitoneoscopic adrenalectomy – Case series
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