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Risk factors for complications after adrenalectomy : results from a comprehensive national database

Thompson, Lo Hallin LU ; Nordenström, Erik LU ; Almquist, Martin LU ; Jacobsson, Helene and Bergenfelz, Anders LU (2017) In Langenbeck's Archives of Surgery 402(2). p.315-322
Abstract

Purpose: Most knowledge regarding outcome after adrenal surgery stems from retrospective studies reported by highly specialized centres. The aim of this study was to report a national experience of adrenalectomy with particular attention to predictive factors for postoperative complications, conversion from endoscopic to open surgery and length of hospital stay. Methods: Adrenalectomies reported in the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery (SQRTPA) 2009–2014 were included. Risk factors for complications, conversion and hospital stay >3 days were assessed using univariable and multivariable logistic regression analysis. Results: There were 659 operations. Endoscopic adrenalectomy was performed in... (More)

Purpose: Most knowledge regarding outcome after adrenal surgery stems from retrospective studies reported by highly specialized centres. The aim of this study was to report a national experience of adrenalectomy with particular attention to predictive factors for postoperative complications, conversion from endoscopic to open surgery and length of hospital stay. Methods: Adrenalectomies reported in the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery (SQRTPA) 2009–2014 were included. Risk factors for complications, conversion and hospital stay >3 days were assessed using univariable and multivariable logistic regression analysis. Results: There were 659 operations. Endoscopic adrenalectomy was performed in 513 (77.8%) operations and almost half of these were robotic assisted. The median length of hospital stay was 3 (range 1–30) days. There was no 30-day mortality. In 43 (6.6%) patients, at least one complication was registered. The only factor associated with complications in multivariable analysis was conversion to open surgery odds ratio (OR) 3.61 (95% confidence interval 1.07 to 12.12). The risk for conversion was associated with tumour size OR 1.03 (1.00 to 1.06) and with malignancy on histopathology OR 8.33 (2.12 to 32.07). Length of hospital stay increased in patients with operation of bilateral tumours OR 3.13, left-sided tumours OR 1.98, hyper secretion of catecholamines OR 2.32, conversion to open surgery OR 42.05 and open surgery OR 115.18. Conclusions: The present study shows that endoscopic surgery is widely used. Complications were associated with conversion and the risk for conversion was associated with tumour size and malignant tumour. Hospital stay was short.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adrenalectomy, Complications, Conversion, Laparoscopic
in
Langenbeck's Archives of Surgery
volume
402
issue
2
pages
315 - 322
publisher
Springer
external identifiers
  • scopus:84997795090
ISSN
1435-2443
DOI
10.1007/s00423-016-1535-8
language
English
LU publication?
no
id
500e3641-0ff7-4036-a461-743519263873
date added to LUP
2016-12-09 08:19:30
date last changed
2018-02-18 04:54:49
@article{500e3641-0ff7-4036-a461-743519263873,
  abstract     = {<p>Purpose: Most knowledge regarding outcome after adrenal surgery stems from retrospective studies reported by highly specialized centres. The aim of this study was to report a national experience of adrenalectomy with particular attention to predictive factors for postoperative complications, conversion from endoscopic to open surgery and length of hospital stay. Methods: Adrenalectomies reported in the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery (SQRTPA) 2009–2014 were included. Risk factors for complications, conversion and hospital stay &gt;3 days were assessed using univariable and multivariable logistic regression analysis. Results: There were 659 operations. Endoscopic adrenalectomy was performed in 513 (77.8%) operations and almost half of these were robotic assisted. The median length of hospital stay was 3 (range 1–30) days. There was no 30-day mortality. In 43 (6.6%) patients, at least one complication was registered. The only factor associated with complications in multivariable analysis was conversion to open surgery odds ratio (OR) 3.61 (95% confidence interval 1.07 to 12.12). The risk for conversion was associated with tumour size OR 1.03 (1.00 to 1.06) and with malignancy on histopathology OR 8.33 (2.12 to 32.07). Length of hospital stay increased in patients with operation of bilateral tumours OR 3.13, left-sided tumours OR 1.98, hyper secretion of catecholamines OR 2.32, conversion to open surgery OR 42.05 and open surgery OR 115.18. Conclusions: The present study shows that endoscopic surgery is widely used. Complications were associated with conversion and the risk for conversion was associated with tumour size and malignant tumour. Hospital stay was short.</p>},
  author       = {Thompson, Lo Hallin and Nordenström, Erik and Almquist, Martin and Jacobsson, Helene and Bergenfelz, Anders},
  issn         = {1435-2443},
  keyword      = {Adrenalectomy,Complications,Conversion,Laparoscopic},
  language     = {eng},
  number       = {2},
  pages        = {315--322},
  publisher    = {Springer},
  series       = {Langenbeck's Archives of Surgery},
  title        = {Risk factors for complications after adrenalectomy : results from a comprehensive national database},
  url          = {http://dx.doi.org/10.1007/s00423-016-1535-8},
  volume       = {402},
  year         = {2017},
}