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Title: Posterior retroperitoneoscopic adrenalectomy: outcomes and lessons learned from initial 50 cases.
Epworth Authors: Cabalag, Miguel
Miller, Julie
Other Authors: Mann, Bruce
Gorelik, Alexandra
Keywords: Posterior Retroperitoneoscopic Adrenalectomy
Laparoscopic Transperitoneal Adrenalectomy
Analgesia Use
Learning Curve
Length of Stay
Operative Time
Outcome Assessment
Retroperitoneal Space
Prospective Studies
Endocrine Surgery
UroRenal, Vascular Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Jun-2015
Publisher: Wiley
Citation: ANZ J Surg. 2015 Jun;85(6):478-82.
Abstract: BACKGROUND: Posterior retroperitoneoscopic adrenalectomy (PRA) is an alternative approach to minimally invasive adrenalectomy, potentially offering less pain and faster recovery compared with laparoscopic transperitoneal adrenalectomy (LA). The authors have recently changed from LA to PRA in suitable patients and audited their first 50 cases. METHODS: Data were prospectively collected for 50 consecutive PRAs performed by the same surgeon. Patient demographics, tumour characteristics, analgesia use, operative and preparation time, length of stay, and complications were recorded. RESULTS: Fifty adrenalectomies were performed in 49 patients. The median (range) age was 58.5 years (30-83) and the majority of patients were female (n = 33, 66.0%). The median (interquartile range (IQR)) preparation time was 35.5 (28.5-50.0) and median operation time was 70.5 (54-85) min, which decreased during the study period. After a learning curve of 15 cases, median operative time reached 61 min. PRA patients required minimal post-operative analgesia, with a median (IQR) of 0 (0-5) mg of intravenous morphine equivalent used. The median (IQR) length of stay was 1 (1-1) day, with 8 (16.0%) same-day discharges. There were four complications: one blood pressure lability from a phaeochromocytoma, one reintubation, one self-limited bleed and one temporary subcostal neuropraxia. There were no conversions to open surgery or deaths. CONCLUSION: Our results support previously published findings that PRA is a safe procedure, with a relatively short learning curve, resulting in minimal post-operative analgesia use and short length of hospital stay.
DOI: 10.1111/ans.12508
PubMed URL:
ISSN: 1445-2197
Journal Title: ANZ Journal of Surgery
Type: Journal Article
Affiliated Organisations: Endocrine Surgery Unit, Royal Melbourne Hospital, Victoria, Australia.
Department of Surgery, University of Melbourne, Victoria, Australia.
Melbourne Epi Centre, Royal Melbourne Hospital, Victoria, Australia.
Type of Clinical Study or Trial: Case Series and Case Reports
Appears in Collections:UroRenal, Vascular

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