CLINICAL RESEARCH
Perioperative complications of adrenalectomy – 12 years of experience from a single center/teaching hospital and literature review
More details
Hide details
Submission date: 2016-03-22
Final revision date: 2016-07-31
Acceptance date: 2016-08-15
Online publication date: 2018-07-20
Publication date: 2018-08-07
Arch Med Sci 2018;14(5):1010-1019
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The perioperative complication rate of adrenalectomy
varies between 1.7% and 30.7% in the medical literature. This study
presents outcomes of adrenalectomy in our center and tries to point out risk
factors for perioperative problems.
Material and methods:
problems.
Material and methods: We retrospectively analyzed all patients who underwent
adrenalectomy in our department from January 2004 to June 2015.
Patient’s sex, indication for procedure, tumor laterality, surgical approach
and surgeon’s case volume were taken into consideration as possible risk
factors for complications.
Results:
were 177 adrenalectomies performed on 170 patients. We
reported 18 (10.2%) perioperative complications, 12 (6.8%) surgical and
6 (3.4%) medical. Laparotomy was a significant risk factor for medical
(p < 0.01) and overall problems (p = 0.02). Operations more expansive than
just adrenalectomy were associated with higher risk of medical complications
(p = 0.01). Procedures performed by surgeons with higher volume were
associated with smaller risk of medical complications (p < 0.01). Right and
left adrenalectomies seem to be related to different kinds of risk – bleeding
on the right, injury of surrounding structures on the left (p = 0.05). Patient’s
sex, indication for procedure, bilateral procedure and side of operation were
not statistically significant risk factors for complications.
Conclusions:
Adrenal glands are surrounded by various anatomic structures
(colon, pancreas, spleen, diaphragm) that may be injured during adrenalectomy.
Complications following a laparoscopic procedure may arise from
the use of monopolar coagulation and the patient’s position on the operating
table. High insufflation pressure during retroperitoneoscopic procedures
may cause subcutaneous emphysema.