Abordaje laparoscópico 3D de la patología suprarrenal

ENG- Introduction: Laparoscopic adrenalectomy, introduced in the 1990s, replaced open surgery as the gold standard. While advantageous, 2D vision has limitations in depth perception, addressed by 3D systems. This study compares the safety and efficacy of 3D versus 2D systems in adrenal tumor surgery...

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Detalles Bibliográficos
Autor: Ranea Goñi, Alejandro Andrés
Tipo de recurso: tesis doctoral
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:CBUC, CESCA
Repositorio:TDR. Tesis Doctorales en Red
OAI Identifier:oai:www.tdx.cat:10803/694442
Acceso en línea:http://hdl.handle.net/10803/694442
Access Level:acceso abierto
Palabra clave:Adrenalectomia laparoscòpica 3D
Adrenalectomía laparoscópica 3D
3D laparoscopic adrenalectomy
Adrenalectomia laparoscòpica 2D
Adrenalectomía laparoscópica 2D
2D laparoscopic adrenalectomy
Comparació
Comparación
Comparison
Tumors suprarenals
Tumores suprarrenales
Adrenal tumors
Cirugia laparoscòpica
Cirugía laparoscópica
Laparoscopic surgery
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616.4
Descripción
Sumario:ENG- Introduction: Laparoscopic adrenalectomy, introduced in the 1990s, replaced open surgery as the gold standard. While advantageous, 2D vision has limitations in depth perception, addressed by 3D systems. This study compares the safety and efficacy of 3D versus 2D systems in adrenal tumor surgery. Objectives: 1) Evaluate morbidity and mortality with 3D vision; 2) Analyze conversions to open surgery; 3) Assess surgical time and intraoperative bleeding; 4) Evaluate hospital stay and causes for prolongation. Methods: Data from 205 patients operated at Dr. Trueta Hospital (2003-2023) were analyzed. Open surgeries, retroperitoneal approaches, and combined procedures were excluded. Statistical analyses and propensity score matching were used to compare 3D and 2D groups. Results: After matching, 104 patients (52 per group) were compared. No complications or conversions to open surgery occurred in the 3D group, while 2 complications (3.8%) and 6 conversions (11.5%) were reported in the 2D group. Surgical time was shorter with 3D (p<0.001), with less intraoperative bleeding (<20 ml) and shorter hospital stays (2 vs. 3 days). Factors increasing hospital stay included complications, prolonged surgical time, and use of surgical drains. Conclusions: Laparoscopic adrenalectomy with 3D vision is safe and effective, offering shorter surgical times, minimal bleeding, and faster recovery