TY - JOUR
T1 - Perioperative outcomes after adrenalectomy for malignant neoplasm in laparoscopic era
T2 - A multicenter retrospective study
AU - Shaligram, Abhijit
AU - Unnirevi, Jayaraj
AU - Meyer, Avishai
AU - Reynoso, Jason F.
AU - Pallati, Pradeep
AU - Oleynikov, Dmitry
PY - 2012/12
Y1 - 2012/12
N2 - BACKGROUND:: This study aims to review perioperative outcomes of adrenalectomy for malignant neoplasm performed by open or laparoscopic technique and comparing them with benign diseases. METHODS:: This study is a multicenter, retrospective analysis utilizing a large administrative database. The University Health System Consortium is an alliance of over 100 academic medical centers and 250 affiliate hospitals. The University Health System Consortium database was accessed using International Classification of Diseases codes. RESULTS:: A total of 6157 patients underwent adrenalectomy between January 2008 and June 2011. Of these, 5101 patients underwent open adrenalectomy (OA) and 1056 underwent adrenalectomy by laparoscopic technique (LA). Comparison between LA and OA showed lower morbidity (4.8% vs. 7.2%, P=0.0007), hospital length of stay (d) (3.23±5.66 vs. 4.35±6.59, P<0.0001), ICU admission rate (18.19% vs. 23.75%, P<0.0001), and cost ($) (9250±14306 vs. 11634±16547, P<0.0001) for LA, with no statistical difference in observed mortality or 30-day readmission rate. We then compared open and laparoscopic procedures performed for benign and malignant diagnoses. CONCLUSIONS:: Overall, LA had better outcomes than OA. When comparisons were made between LA and OA for benign adrenal diseases, all outcomes were significantly better in the laparoscopic group. There were, however, no statistical differences when LA was compared with OA for malignant diagnoses.
AB - BACKGROUND:: This study aims to review perioperative outcomes of adrenalectomy for malignant neoplasm performed by open or laparoscopic technique and comparing them with benign diseases. METHODS:: This study is a multicenter, retrospective analysis utilizing a large administrative database. The University Health System Consortium is an alliance of over 100 academic medical centers and 250 affiliate hospitals. The University Health System Consortium database was accessed using International Classification of Diseases codes. RESULTS:: A total of 6157 patients underwent adrenalectomy between January 2008 and June 2011. Of these, 5101 patients underwent open adrenalectomy (OA) and 1056 underwent adrenalectomy by laparoscopic technique (LA). Comparison between LA and OA showed lower morbidity (4.8% vs. 7.2%, P=0.0007), hospital length of stay (d) (3.23±5.66 vs. 4.35±6.59, P<0.0001), ICU admission rate (18.19% vs. 23.75%, P<0.0001), and cost ($) (9250±14306 vs. 11634±16547, P<0.0001) for LA, with no statistical difference in observed mortality or 30-day readmission rate. We then compared open and laparoscopic procedures performed for benign and malignant diagnoses. CONCLUSIONS:: Overall, LA had better outcomes than OA. When comparisons were made between LA and OA for benign adrenal diseases, all outcomes were significantly better in the laparoscopic group. There were, however, no statistical differences when LA was compared with OA for malignant diagnoses.
KW - adrenalectomy
KW - laparoscopy
KW - malignant neoplasm
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U2 - 10.1097/SLE.0b013e3182747b92
DO - 10.1097/SLE.0b013e3182747b92
M3 - Review article
C2 - 23238380
AN - SCOPUS:84873837434
SN - 1530-4515
VL - 22
SP - 523
EP - 525
JO - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
JF - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
IS - 6
ER -