Single center experience with laparoscopic adrenalectomy on a large clinical series: lessons learned from 273 cases: a retrospective cohort study

Abstract

Objectives: We aim to evaluate the risk of laparoscopic adrenalectomy (LA) for large adrenal tumors and the risk of learning curve. Design: Single centre, retrospective study Setting: Uludag University, Bursa, Turkey Subjects: A study in a large patient population (N=273) who underwent LA between 2006 and 2017. Interventions: The patients were divided into two study groups according to tumour size as estimated by pathologic specimen maximum diameter, Group A (less than 5cm) and group B (larger than 5cm). In addition, to evaluate learning curve of LA, the patients were divided into two groups according to time interval: the first period was 2006 to 2011, and the second period 2012-2017. Main outcome measures: To evaluate the risk of learning curve and tumour size Results: There was no statistical difference between the two groups for per-operative and postoperative complications according to tumour size <5 or >= 5 cm, and there was statistical difference between the two groups for operation time, length of hospital stay; but no statistical difference for postoperative complications according to time interval. Conclusion: LA in large adrenal masses (5 cm or larger) is not associated with longer operative time, increased blood loss and longer hospital stay, without affecting perioperative morbidity, Hence, the size of an adrenal mass should not be the only factor in determining whether LA or not. Besides, learning curve may affect outcomes of LA.