Predictors of complication after adrenalectomy
Carregando...
Citações na Scopus
5
Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
BRAZILIAN SOC UROL
Autores
Citação
INTERNATIONAL BRAZ J UROL, v.45, n.3, p.514-522, 2019
Resumo
Purpose: To investigate risk factors for complications in patients undergoing adrenalectomy. Materials and Methods: A retrospective search of our institutional database was performed of patients who underwent adrenalectomy, between 2014 and 2018. Clinical parameters and adrenal disorder characteristics were assessed and correlated to intra and post-operative course. Complications were analyzed within 30-days after surgery. A logistic regression was performed in order to identify independent predictors of morbidity in patients after adrenalectomy. Results: The files of 154 patients were reviewed. Median age and Body Mass Index (BMI) were 52-years and 27.8kg/m(2), respectively. Mean tumor size was 4.9 +/- 4cm. Median surgery duration and estimated blood loss were 140min and 50mL, respectively. There were six conversions to open surgery. Minor and major post-operative complications occurred in 17.5% and 8.4% of the patients. Intra-operative complications occurred in 26.6% of the patients. Four patients died. Mean hospitalization duration was 4-days (Interquartile Range: 3-8). Patients age (p=0.004), comorbidities (p=0.003) and pathological diagnosis (p=0.003) were independent predictors of post-operative complications. Tumor size (p<0.001) and BMI (p=0.009) were independent predictors of intra-operative complications. Pathological diagnosis (p<0.001) and Charlson score (p=0.013) were independent predictors of death. Conclusion: Diligent care is needed with older patients, with multiple comorbidities and harboring unfavorable adrenal disorders (adrenocortical carcinoma and pheocromocytoma), who have greater risk of post-operative complications. Patients with elevated BMI and larger tumors have higher risk of intra, but not of post-operative complications.
Palavras-chave
Adrenalectomy, Morbidity, Pathology
Referências
- Bergamini C, 2011, SURG ENDOSC, V25, P3845, DOI 10.1007/s00464-011-1804-0
- Bittner JG, 2013, SURG ENDOSC, V27, P2342, DOI 10.1007/s00464-013-2789-7
- Brunt LM, 2002, SURG ENDOSC, V16, P252, DOI 10.1007/s00464-001-8302-8
- CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8
- Clavien PA, 2009, ANN SURG, V250, P187, DOI 10.1097/SLA.0b013e3181b13ca2
- Constantinides VA, 2012, BRIT J SURG, V99, P1639, DOI 10.1002/bjs.8921
- Conzo G, 2018, BMC SURG, V18, DOI 10.1186/s12893-017-0333-8
- Coste T, 2017, SURG ENDOSC, V31, P2752, DOI 10.1007/s00464-017-5437-9
- Coste T, 2017, SURG ENDOSC, V31, P2743, DOI 10.1007/s00464-016-4830-0
- Hattori S, 2012, J ENDOUROL, V26, P1463, DOI 10.1089/end.2012.0274
- Horesh N, 2016, J LAPAROENDOSC ADV S, V26, P453, DOI 10.1089/lap.2015.0625
- HULL CJ, 1986, BRIT J ANAESTH, V58, P1453, DOI 10.1093/bja/58.12.1453
- Kazaure HS, 2011, ANN SURG ONCOL, V18, P2714, DOI 10.1245/s10434-011-1757-5
- Livhits M, 2014, SURGERY, V156, P1531, DOI 10.1016/j.surg.2014.08.047
- Marcadis AR, 2017, J SURG RES, V219, P259, DOI 10.1016/j.jss.2017.05.116
- MCLEOD MK, 1991, J NATL MED ASSOC, V83, P161
- Miller BS, 2012, SURGERY, V152, P1150, DOI 10.1016/j.surg.2012.08.024
- Monn MF, 2015, BJU INT, V115, P288, DOI 10.1111/bju.12747
- Murphy MM, 2010, SURG ENDOSC, V24, P2518, DOI 10.1007/s00464-010-0996-z
- Nieman LK, 2010, J CLIN ENDOCR METAB, V95, P4106, DOI 10.1210/jc.2010-0457
- Parikh PP, 2018, AM J SURG, V216, P293, DOI 10.1016/j.amjsurg.2017.08.018
- Park HS, 2009, ARCH SURG-CHICAGO, V144, P1060, DOI 10.1001/archsurg.2009.191
- Pedziwiatr M, 2015, INT J SURG, V20, P88, DOI 10.1016/j.ijsu.2015.06.020
- Satava RM, 2005, MINIM INVASIV THER, V14, P257, DOI 10.1080/13645700500274112
- Shen ZJ, 2007, J ENDOUROL, V21, P1333, DOI 10.1089/end.2006.450
- Srougi V, 2016, INT BRAZ J UROL, V42, P671, DOI 10.1590/S1677-5538.IBJU.2015.0503
- Srougi V, 2016, UROLOGY, V90, P217, DOI 10.1016/j.urology.2015.11.043
- Turrentine FE, 2007, J AM COLL SURGEONS, V204, P1273, DOI 10.1016/j.jamcollsurg.2007.03.014