Faculty Collaboration Database

Is previous same quadrant surgery a contraindication to laparoscopic adrenalectomy? Surgery 2012 Dec;152(6):1211-7

Date

10/17/2012

Pubmed ID

23068085

DOI

10.1016/j.surg.2012.08.028

Scopus ID

2-s2.0-84869498128 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

BACKGROUND: Previous abdominal surgery may present a challenge to safely completing laparoscopic adrenalectomy. We evaluated the impact of previous ipsilateral upper abdominal surgery on laparoscopic adrenalectomy outcomes.

METHODS: A retrospective analysis of prospective databases was performed for patients that underwent laparoscopic transabdominal adrenalectomy at 2 tertiary centers between 2001 and 2011. Patients with previous ipsilateral upper abdominal surgery, contralateral upper abdominal surgery, or no relevant surgery were compared.

RESULTS: Of the 217 patients, 38 (17%) had previous ipsilateral upper abdominal surgeries, 17 (8%) had contralateral upper abdominal surgeries, and 162 (75%) had no relevant surgery. Adhesions were more common in the ipsilateral upper abdominal surgery group (63% vs 24% vs 17%; P < .001). Mean operative times (173 ± 100 vs 130 ± 76 vs 149 ± 77 minutes; P = .16) and intraoperative complication rates (3% vs 0% vs 3%; P = .55) were not different. The rate of conversion to open surgery was similar for the 3 groups (11% vs 6% vs 3%; P = .08); all 4 conversions in the ipsilateral upper abdominal surgery group followed previous open procedures. Mean duration of stay and postoperative complication rates were also comparable between the 3 groups.

CONCLUSION: Laparoscopic adrenalectomy in patients with previous ipsilateral upper abdominal surgery is feasible and safe, with comparable outcomes to those without previous relevant surgery, including contralateral upper abdominal surgery.

Author List

Mazeh H, Froyshteter AB, Wang TS, Amin AL, Evans DB, Sippel RS, Chen H, Yen TW

Authors

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin
Tracy S. Wang MD, MPH Professor in the Surgery department at Medical College of Wisconsin
Tina W F Yen MD, MS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abdomen
Adrenal Gland Neoplasms
Adrenalectomy
Adult
Aged
Aged, 80 and over
Contraindications
Conversion to Open Surgery
Female
Humans
Intraoperative Complications
Laparoscopy
Male
Middle Aged
Postoperative Complications
Young Adult