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Experience of an endocrine surgeon in laparoscopic transperitoneal adrenalectomy

BACKGROUND: Laparoscopic adrenalectomy (LA) is currently recognized as the gold standard for the treatment of most adrenal lesions, with a high safety and feasibility profile. This study aimed to present the extensive experience of a specialized endocrine surgeon in LA in a relatively large series o...

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Autores principales: Teksöz, Serkan, Kılboz, Bekir Burak, Bükey, Yusuf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6739991/
https://www.ncbi.nlm.nih.gov/pubmed/31510984
http://dx.doi.org/10.1186/s12893-019-0599-0
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author Teksöz, Serkan
Kılboz, Bekir Burak
Bükey, Yusuf
author_facet Teksöz, Serkan
Kılboz, Bekir Burak
Bükey, Yusuf
author_sort Teksöz, Serkan
collection PubMed
description BACKGROUND: Laparoscopic adrenalectomy (LA) is currently recognized as the gold standard for the treatment of most adrenal lesions, with a high safety and feasibility profile. This study aimed to present the extensive experience of a specialized endocrine surgeon in LA in a relatively large series of patients. METHODS: A total of 116 LAs performed from June 2009 to 2018 were evaluated in terms of adrenal pathologies, perioperative management, complications, conversions, tumor size, operative time, and learning curve. The learning curve was assessed using the cumulative sum (CUSUM(OT)) technique. RESULTS: Of 116 LAs, 107 (92.2%) were completed successfully, 77 (72%) of which were for Cushing’s syndrome (n = 43, 55.8%), pheochromocytoma (n = 26, 33.8%), and Conn’s syndrome (n = 8, 10.4%). Conversion was required in 9 cases (7.8%), the most common cause being limited space complicating dissection (n = 3). The mean operative time for successful LAs (unilateral 85, bilateral 22) was 74.7 min (range 40–210 min) and the mean hospital stay was 1.7 days (range 1–5 days). Gender, tumor size and body mass index were found to have no significant relationship with the operative time (p > 0.05). Postoperative normalization in hormone profiles was obtained in all patients but one. Aside from grade-I port-site infections in four patients (3.7%), no postoperative major complications and 30-day mortality were observed. On the CUSUM(OT) graph, the learning period covered the first 34 operations. CONCLUSIONS: Laparoscopic adrenalectomy is safe and advantageous, but requires a dedicated team involving experienced endocrine surgeons who have achieved competency after completion of the learning curve.
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spelling pubmed-67399912019-09-16 Experience of an endocrine surgeon in laparoscopic transperitoneal adrenalectomy Teksöz, Serkan Kılboz, Bekir Burak Bükey, Yusuf BMC Surg Research Article BACKGROUND: Laparoscopic adrenalectomy (LA) is currently recognized as the gold standard for the treatment of most adrenal lesions, with a high safety and feasibility profile. This study aimed to present the extensive experience of a specialized endocrine surgeon in LA in a relatively large series of patients. METHODS: A total of 116 LAs performed from June 2009 to 2018 were evaluated in terms of adrenal pathologies, perioperative management, complications, conversions, tumor size, operative time, and learning curve. The learning curve was assessed using the cumulative sum (CUSUM(OT)) technique. RESULTS: Of 116 LAs, 107 (92.2%) were completed successfully, 77 (72%) of which were for Cushing’s syndrome (n = 43, 55.8%), pheochromocytoma (n = 26, 33.8%), and Conn’s syndrome (n = 8, 10.4%). Conversion was required in 9 cases (7.8%), the most common cause being limited space complicating dissection (n = 3). The mean operative time for successful LAs (unilateral 85, bilateral 22) was 74.7 min (range 40–210 min) and the mean hospital stay was 1.7 days (range 1–5 days). Gender, tumor size and body mass index were found to have no significant relationship with the operative time (p > 0.05). Postoperative normalization in hormone profiles was obtained in all patients but one. Aside from grade-I port-site infections in four patients (3.7%), no postoperative major complications and 30-day mortality were observed. On the CUSUM(OT) graph, the learning period covered the first 34 operations. CONCLUSIONS: Laparoscopic adrenalectomy is safe and advantageous, but requires a dedicated team involving experienced endocrine surgeons who have achieved competency after completion of the learning curve. BioMed Central 2019-09-11 /pmc/articles/PMC6739991/ /pubmed/31510984 http://dx.doi.org/10.1186/s12893-019-0599-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Teksöz, Serkan
Kılboz, Bekir Burak
Bükey, Yusuf
Experience of an endocrine surgeon in laparoscopic transperitoneal adrenalectomy
title Experience of an endocrine surgeon in laparoscopic transperitoneal adrenalectomy
title_full Experience of an endocrine surgeon in laparoscopic transperitoneal adrenalectomy
title_fullStr Experience of an endocrine surgeon in laparoscopic transperitoneal adrenalectomy
title_full_unstemmed Experience of an endocrine surgeon in laparoscopic transperitoneal adrenalectomy
title_short Experience of an endocrine surgeon in laparoscopic transperitoneal adrenalectomy
title_sort experience of an endocrine surgeon in laparoscopic transperitoneal adrenalectomy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6739991/
https://www.ncbi.nlm.nih.gov/pubmed/31510984
http://dx.doi.org/10.1186/s12893-019-0599-0
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