Clinical Outcomes of patients undergoing laparoscopic adrenalectomy in Khon Kaen Hospital: A retrospective study from 2014 to 2025

Abstract

Laparoscopic adrenalectomy is the standard treatment for most adrenal tumors due to its advantages over open surgery, including reduced blood loss, less postoperative pain and shorter hospital stay; however, data from Thailand are limited. This retrospective study evaluated the clinical outcomes of laparoscopic adrenalectomy at Khon Kaen Hospital. Medical records were reviewed for demographics, comorbidities, tumor characteristics, prolonged length of stay (LOS) and complications. Forty-five patients were included; 62.2% were female, mean age was 45.3 years (SD = 13) and hypertension was the most common comorbidity (82.2%). Tumor size was 2.64 cm (SD = 1.6), with 20.0% ≥4 cm, and 68.9% were functional tumors. Median operative time and blood loss were 171 minutes and 15 mL, respectively, with a 4.4% conversion rate to open surgery. Overall complications occurred in 8.9%, with no major complications or mortality; median postoperative LOS was 4 days, and 22.2% had prolonged LOS. On univariate analysis, tumor size was significantly associated with prolonged LOS (OR 1.77; 95% CI 1.10–2.86; p = 0.018 per 1-cm increase). Patients with tumors ≥4 cm had a significantly higher risk of prolonged LOS compared with those with tumors <4 cm (OR 7.75; 95% CI 1.54–39.12;
p = 0.013). Adrenal adenoma was the most common pathology (66.7%). In conclusion, laparoscopic adrenalectomy is safe and effective with low complication rates, and tumor size is an important factor associated with prolonged LOS.