Complicacions perioperatòries de l’adrenalectomia laparoscòpica. Experiència a la província de Girona
INTRODUCTION: Adrenal masses are one of the most common tumors, being incidentally diagnosed in 5% of patients undergoing imaging tests. Until the beginning of the 1990s, all adrenal surgical treatment was performed through open surgery, but since the description of laparoscopic adrenalectomy in 199...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | CBUC, CESCA |
| Repositorio: | TDR. Tesis Doctorales en Red |
| OAI Identifier: | oai:www.tdx.cat:10803/690469 |
| Acceso en línea: | http://hdl.handle.net/10803/690469 |
| Access Level: | acceso abierto |
| Palabra clave: | Adrenalectomia laparoscòpica Adrenalectomía laparoscópica Laparoscopic adrenalectomy Complicacions postoperatòries Complicaciones postoperatorias Postoperative complications Estada hospitalària Estada hospitalaria Hospital stay Glàndules suprarenals Glándulas suprarrenales Adrenal glands Cirurgia laparoscòpica Cirugía laparoscópica Laparoscopic surgery Factors de risc Factores de riesgo Risk factors 616.4 617 |
| Sumario: | INTRODUCTION: Adrenal masses are one of the most common tumors, being incidentally diagnosed in 5% of patients undergoing imaging tests. Until the beginning of the 1990s, all adrenal surgical treatment was performed through open surgery, but since the description of laparoscopic adrenalectomy in 1992, its use has become widespread and is now considered the gold standard. However, laparoscopic adrenalectomy is an advanced minimally invasive surgery that presents a postoperative complication rate that can reach up to 18% according to published literature. The Endocrine Surgery team at Hospital Universitari Dr Josep Trueta in Girona introduced laparoscopy in adrenal gland surgery in 2003, obtaining results comparable to those of national and international literature. OBJECTIVES: The objectives of this study are 1) To analyze the morbidity rate and types of complications of laparoscopic adrenalectomy, 2) To analyze the possible risk factors for complications, 3) To analyze the possible risk factors for conversion, 4) To analyze the mortality rate and its causes, and 5) To analyze factors that increase hospital stay. PATIENTS AND METHODS: This study includes all patients treated for an adrenal tumor at Hospital Dr Trueta in Girona from April 2003 to December 2022. Patients undergoing open surgery or retroperitoneoscopic approaches, bilateral adrenalectomies, patients undergoing other surgical procedures during laparoscopy, minors, pregnant women, and patients unfit for anesthesia are excluded from the study analysis. In all patients, a lateral transperitoneal laparoscopic approach was performed. Demographic and analytical variables, preoperative, intraoperative, and postoperative variables were collected. To compare continuous variables between groups, we used the Student's t-test for normally distributed variables and the Mann-Whitney U test for non-normally distributed variables. To compare categorical variables between groups, the Chi-square or Fisher's exact test was used, as appropriate. Associations between outcomes and variables were tested using univariate and linear logistic regression. Variables with p ≤ 0.10 in unadjusted logistic or linear regression were included in multiple logistic or linear regression models to generate adjusted odds ratios (OR) or means. For all tests, significance levels of p < 0.05 were considered |
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