ARTICLE DOWNLOAD

Risk factors for open conversion of lateral transperitoneal laparoscopic adrenalectomy: retrospective cohort study of the Spanish Adrenal Surgery Group (SASG)

10$
ARTICLE DOWNLOAD

Risk factors for open conversion of lateral transperitoneal laparoscopic adrenalectomy: retrospective cohort study of the Spanish Adrenal Surgery Group (SASG)

10$

Oscar Vidal, David Saavedra-Perez, Juan Manuel Martos, Aitor de la Quintana, Jose Ignacio Rodriguez, Jesus Villar, Joaquin Ortega, Antonio Moral, Manuel Duran, Mauro Valentini & Laureano Fernandez-Cruz

Abstract

Background

Laparoscopic adrenalectomy has become the standard of care for treating adrenal tumors. Conversion from laparoscopic adrenalectomy to an open approach during surgery may be necessary in some cases. This study aimed to identify the risk factors for open conversion of laparoscopic adrenalectomy.

Methods

Retrospective analysis of all consecutive patients undergoing lateral transperitoneal laparoscopic adrenalectomy in six endocrine surgery units of the Spanish Adrenal Surgery Group (SASG) between January 2005 and December 2017. Demographic, clinical, surgical, and histopathologic characteristics were recorded. Risk factors for conversion were assessed by logistic regression analysis.

Results

Of a total of 865 patients included in the study, 58 (6.7%) required conversion to open surgery. In the univariate analysis, factors associated with conversion from laparoscopic to open adrenalectomy were body mass index (BMI) ≥ 30 kg/m2 (P = 0.002), previous abdominal surgery (P = 0.015), tumor size > 5 cm (P = 0.001), and surgery for pheochromocytoma (P = 0.034). In the multivariate analysis, independent risk factors were BMI ≥ 30 kg/m2 [odds ratio (OR) 4.26, 95% confidence interval (CI) 2.81–8.75; P = 0.001], tumor size > 5 cm (OR 10.15, 95% CI 4.24–28.31; P < 0.001), and surgery for pheochromocytoma (OR 2.96, 95% CI 1.89–11.55; P = 0.015).

Conclusions

Obesity, tumor size, and pheochromocytoma as the type of adrenal tumor were predictive factors for intraoperative conversion from laparoscopic to open adrenalectomy. Preoperative assessment of these characteristics should be valuable to clinicians in discussing conversion risk in patients and for surgical planning.


Only units of this product remain
Year 2020
Language English
Format PDF
DOI 10.1007/s00464-019-07264-1