Outcomes after laparoscopic adrenalectomy

Prateek K. Gupta, Bala Natarajan, Pradeep K. Pallati, Himani Gupta, Jyothsna Sainath, Robert Joseph Fitzgibbons

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Laparoscopic adrenalectomy (LA) has become the standard of care for many conditions requiring removal of the adrenal gland. Previous studies on outcomes after LA have had limitations. This report describes the 30-day morbidity and mortality rates after LA and analyzes factors affecting operative time, hospital length of stay (LOS), and postoperative morbidity. Methods: Patients undergoing LA in 2007and 2008 were identified from the American College of Surgeons' National Surgical Quality Improvement Program (NSQIP). Using multivariate analysis of variance (ANOVA) and logistic regression, 52 demographic/comorbidity variables were analyzed to ascertain factors affecting operative time, LOS, and morbidity. Results: The mean age of the 988 patients was 53.5 ± 13.7 years, and 60% of the patients were women. The mean body mass index (BMI) of the patients was 31.8 ± 7.9 kg/m2. The 30-day morbidity and mortality rates were 6.8% and 0.5%, respectively. The mean and median operative times were 146.7 ± 66.8 min and 134 min, respectively. The mean and median hospital stays were 2.6 ± 3.1 days and 2 days, respectively. Compared with independent status, totally dependent functional status was associated with a 9.5-day increase in LOS (P = 0.0006) and an increased risk for postoperative morbidity (odds ratio [OR], 14.7; 95% confidence interval [CI], 2.4-91.9; P <0.0001). Peripheral vascular disease (OR, 7.3; 95% CI, 1.7-31.7; P = 0.008) also was associated with increased 30-day morbidity. Neurologic and respiratory comorbidities were associated with increased LOS (P <0.05). American Society of Anesthesiology (ASA) class 4 patients had a longer operative time than ASA class 1 patients (P = 0.002). Conclusions: The morbidity and mortality rates after LA are low. Dependent functional status and peripheral vascular disease predispose to postoperative morbidity. Dependent status, higher ASA class, and respiratory and neurologic comorbidities are associated with longer operative time and LOS.

Original languageEnglish
Pages (from-to)784-794
Number of pages11
JournalSurgical Endoscopy
Volume25
Issue number3
DOIs
StatePublished - Mar 2011

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Adrenalectomy
Length of Stay
Morbidity
Operative Time
Anesthesiology
Comorbidity
Peripheral Vascular Diseases
Nervous System
Mortality
Odds Ratio
Confidence Intervals
Standard of Care
Adrenal Glands
Quality Improvement
Statistical Factor Analysis
Analysis of Variance
Body Mass Index
Multivariate Analysis
Logistic Models
Demography

All Science Journal Classification (ASJC) codes

  • Surgery

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Gupta, P. K., Natarajan, B., Pallati, P. K., Gupta, H., Sainath, J., & Fitzgibbons, R. J. (2011). Outcomes after laparoscopic adrenalectomy. Surgical Endoscopy, 25(3), 784-794. https://doi.org/10.1007/s00464-010-1256-y

Outcomes after laparoscopic adrenalectomy. / Gupta, Prateek K.; Natarajan, Bala; Pallati, Pradeep K.; Gupta, Himani; Sainath, Jyothsna; Fitzgibbons, Robert Joseph.

In: Surgical Endoscopy, Vol. 25, No. 3, 03.2011, p. 784-794.

Research output: Contribution to journalArticle

Gupta, PK, Natarajan, B, Pallati, PK, Gupta, H, Sainath, J & Fitzgibbons, RJ 2011, 'Outcomes after laparoscopic adrenalectomy', Surgical Endoscopy, vol. 25, no. 3, pp. 784-794. https://doi.org/10.1007/s00464-010-1256-y
Gupta PK, Natarajan B, Pallati PK, Gupta H, Sainath J, Fitzgibbons RJ. Outcomes after laparoscopic adrenalectomy. Surgical Endoscopy. 2011 Mar;25(3):784-794. https://doi.org/10.1007/s00464-010-1256-y
Gupta, Prateek K. ; Natarajan, Bala ; Pallati, Pradeep K. ; Gupta, Himani ; Sainath, Jyothsna ; Fitzgibbons, Robert Joseph. / Outcomes after laparoscopic adrenalectomy. In: Surgical Endoscopy. 2011 ; Vol. 25, No. 3. pp. 784-794.
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abstract = "Background: Laparoscopic adrenalectomy (LA) has become the standard of care for many conditions requiring removal of the adrenal gland. Previous studies on outcomes after LA have had limitations. This report describes the 30-day morbidity and mortality rates after LA and analyzes factors affecting operative time, hospital length of stay (LOS), and postoperative morbidity. Methods: Patients undergoing LA in 2007and 2008 were identified from the American College of Surgeons' National Surgical Quality Improvement Program (NSQIP). Using multivariate analysis of variance (ANOVA) and logistic regression, 52 demographic/comorbidity variables were analyzed to ascertain factors affecting operative time, LOS, and morbidity. Results: The mean age of the 988 patients was 53.5 ± 13.7 years, and 60{\%} of the patients were women. The mean body mass index (BMI) of the patients was 31.8 ± 7.9 kg/m2. The 30-day morbidity and mortality rates were 6.8{\%} and 0.5{\%}, respectively. The mean and median operative times were 146.7 ± 66.8 min and 134 min, respectively. The mean and median hospital stays were 2.6 ± 3.1 days and 2 days, respectively. Compared with independent status, totally dependent functional status was associated with a 9.5-day increase in LOS (P = 0.0006) and an increased risk for postoperative morbidity (odds ratio [OR], 14.7; 95{\%} confidence interval [CI], 2.4-91.9; P <0.0001). Peripheral vascular disease (OR, 7.3; 95{\%} CI, 1.7-31.7; P = 0.008) also was associated with increased 30-day morbidity. Neurologic and respiratory comorbidities were associated with increased LOS (P <0.05). American Society of Anesthesiology (ASA) class 4 patients had a longer operative time than ASA class 1 patients (P = 0.002). Conclusions: The morbidity and mortality rates after LA are low. Dependent functional status and peripheral vascular disease predispose to postoperative morbidity. Dependent status, higher ASA class, and respiratory and neurologic comorbidities are associated with longer operative time and LOS.",
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N2 - Background: Laparoscopic adrenalectomy (LA) has become the standard of care for many conditions requiring removal of the adrenal gland. Previous studies on outcomes after LA have had limitations. This report describes the 30-day morbidity and mortality rates after LA and analyzes factors affecting operative time, hospital length of stay (LOS), and postoperative morbidity. Methods: Patients undergoing LA in 2007and 2008 were identified from the American College of Surgeons' National Surgical Quality Improvement Program (NSQIP). Using multivariate analysis of variance (ANOVA) and logistic regression, 52 demographic/comorbidity variables were analyzed to ascertain factors affecting operative time, LOS, and morbidity. Results: The mean age of the 988 patients was 53.5 ± 13.7 years, and 60% of the patients were women. The mean body mass index (BMI) of the patients was 31.8 ± 7.9 kg/m2. The 30-day morbidity and mortality rates were 6.8% and 0.5%, respectively. The mean and median operative times were 146.7 ± 66.8 min and 134 min, respectively. The mean and median hospital stays were 2.6 ± 3.1 days and 2 days, respectively. Compared with independent status, totally dependent functional status was associated with a 9.5-day increase in LOS (P = 0.0006) and an increased risk for postoperative morbidity (odds ratio [OR], 14.7; 95% confidence interval [CI], 2.4-91.9; P <0.0001). Peripheral vascular disease (OR, 7.3; 95% CI, 1.7-31.7; P = 0.008) also was associated with increased 30-day morbidity. Neurologic and respiratory comorbidities were associated with increased LOS (P <0.05). American Society of Anesthesiology (ASA) class 4 patients had a longer operative time than ASA class 1 patients (P = 0.002). Conclusions: The morbidity and mortality rates after LA are low. Dependent functional status and peripheral vascular disease predispose to postoperative morbidity. Dependent status, higher ASA class, and respiratory and neurologic comorbidities are associated with longer operative time and LOS.

AB - Background: Laparoscopic adrenalectomy (LA) has become the standard of care for many conditions requiring removal of the adrenal gland. Previous studies on outcomes after LA have had limitations. This report describes the 30-day morbidity and mortality rates after LA and analyzes factors affecting operative time, hospital length of stay (LOS), and postoperative morbidity. Methods: Patients undergoing LA in 2007and 2008 were identified from the American College of Surgeons' National Surgical Quality Improvement Program (NSQIP). Using multivariate analysis of variance (ANOVA) and logistic regression, 52 demographic/comorbidity variables were analyzed to ascertain factors affecting operative time, LOS, and morbidity. Results: The mean age of the 988 patients was 53.5 ± 13.7 years, and 60% of the patients were women. The mean body mass index (BMI) of the patients was 31.8 ± 7.9 kg/m2. The 30-day morbidity and mortality rates were 6.8% and 0.5%, respectively. The mean and median operative times were 146.7 ± 66.8 min and 134 min, respectively. The mean and median hospital stays were 2.6 ± 3.1 days and 2 days, respectively. Compared with independent status, totally dependent functional status was associated with a 9.5-day increase in LOS (P = 0.0006) and an increased risk for postoperative morbidity (odds ratio [OR], 14.7; 95% confidence interval [CI], 2.4-91.9; P <0.0001). Peripheral vascular disease (OR, 7.3; 95% CI, 1.7-31.7; P = 0.008) also was associated with increased 30-day morbidity. Neurologic and respiratory comorbidities were associated with increased LOS (P <0.05). American Society of Anesthesiology (ASA) class 4 patients had a longer operative time than ASA class 1 patients (P = 0.002). Conclusions: The morbidity and mortality rates after LA are low. Dependent functional status and peripheral vascular disease predispose to postoperative morbidity. Dependent status, higher ASA class, and respiratory and neurologic comorbidities are associated with longer operative time and LOS.

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