Open AccessEvolution of Minimally Invasive Adrenal Surgery at a Tertiary Care Centre in Oman
Author(s) -
Najeeb AbuDraz,
Mohamed S Al-Masruri,
Ghalib Al Badaai,
Yamam Al-Shamari,
Omayma Elshafie,
Khurram Siddiqui
Publication year - 2023
Publication title -
sultan qaboos university medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.258
H-Index - 27
eISSN - 2075-0528
pISSN - 2075-051X
DOI - 10.18295/squmj.4.2022.031
Subject(s) - medicine , adrenalectomy , surgery , blood loss , retrospective cohort study , adenoma , body mass index , pheochromocytoma , laparoscopy , complication , general surgery
Objective: We reviewed the case records of adrenalectomy cases at our institution between January 2010 and December 2020 and report the outcomes of both open and laparoscopic adrenalectomy (LA). Methods: This retrospective study included patients who underwent adrenal surgery from January 2010 to December 2020. We recorded demographic details, indications, surgical approach, intra operative data and complications. The final pathology and outcome at the last follow up was also documented. Data was analyzed through the SPSS program. Results: Fifty two patients underwent 61 adrenalectomy procedures. Six patients had bilateral procedure and 3 patients underwent redo surgery accounting for 55 subjects. Open adrenalectomy (OA) was performed on 11 patients and 44 patients underwent LA. Majority of the patients (27) were obese having BMI > 30. Functional adenoma was excised in 36 patients with final diagnosis of Conn’s syndrome in 15, Pheochromocytoma in 13 and Cushing syndrome in 9 patients. Five patients had surgery for oncological indications. Nonfunctional adenoma was excised in 13 patients, with a mean size of 8.9 cm (range 4-15 cm). The mean duration of surgery was less in laparoscopic procedure (199 min) compared to open (246 min). The mean estimated blood loss in LA was significantly less (108ml vs 450 ml, p-value < 0.05). Out of 55 subjects only 1 patients developed Clavien-dindo grade 2 complication. Conclusion: At our institution both laparoscopic and open adrenalectomy were safely performed. There is a trend to perform LA and with experience the duration of surgery and EBL are demonstrating positive trend.
Keywords: Adrenal Gland Surgery; Laparoscopic Adrenalectomy; Open Adrenalectomy; Pheochromocytoma; Adrenal Metastasis; Nonfunctional Adrenal Tumors; Oman.