Laparoscopic Adrenalectomy: A 10-year Experience at Maharat Nakhon Ratchasima Hospital

Abstract

Background: Currently, laparoscopic adrenalectomy is considered the gold standard approach for surgical treatment of adrenal tumors. Urology Division Surgery Department at Maharat Nakhon Ratchasima Hospital has been performing laparoscopic adrenalectomy since 2012. This study aimed to analyze the treatment outcomes of patients who underwent laparoscopic adrenalectomy for adrenal tumors and compare surgical parameters and outcomes before and after reached learning curve
Methods: This retrospective study analyzed data from October 2012 to September 2022. Patients who underwent laparoscopic adrenalectomy by Urology Division Surgery Department at Maharat Nakhon Ratchasima Hospital were included.
Results: The study included 80 patients, comprising 22 males (28.7%) and 58 females (71.3%) with a mean age of 46.5 years (range: 23-74). Diagnoses included 63 cases (78.7%) of aldosterone-producing adenoma (APA), 6 cases (7.5%) of pheochromocytoma, and 6 cases (7.5%) of Cushing's syndrome. The surgical success rate was 96.5%, with a conversion rate to open surgery of 2.5% (2 cases). The average tumor size was 2.3 cm (range: 0.7-6), and the mean surgical duration was 138 minutes (range: 72-310). The average hospital stay was 4.7 days (range: 2-10), and the mean blood loss was 86.6 milliliters. There was one case (1.3%) of pancreatic injury. Significant statistical improvements were observed in operative time, hospital stay, and blood loss between the early and later experience groups (P Value < 0.05).
Conclusions: laparoscopic adrenalectomy for adrenal tumors can be performed successfully in regional hospitals, and surgical outcomes improve with experience, particularly after reached 40 procedures.