PREDICTORS OF POSTOPERATIVE COMPLICATIONS AFTER ADRENALECTOMY markogiannakis@yahoo.com

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PREDICTORS OF POSTOPERATIVE COMPLICATIONS AFTER ADRENALECTOMY

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Greece

Oral or Poster

Our objective was to identify and analyze predictors of postoperative complications following adrenalectomy.

This is a prospective study of all adrenalectomies in our department during the last decade. Recorded data were: age, sex, final diagnosis, malignancy, functionality, previous abdominal surgery, type of operation (laparoscopic, open or conversion to open), adrenalectomy side, concurrent surgical procedure, intraoperative complications, operative time, adrenal gland weight and diameter, adrenal tumor diameter and hospital stay. Cases with postoperative complications were compared with those without complications.

During the study period, 151 adrenalectomies were performed (female: 60.9%, mean age: 54.1±12.8 years). Diagnosis was non-functioning adenoma in 33.1%, ACTH-independent Cushing’s syndrome 16.6%, pheochromocytoma 16.6%, Conn’s syndrome 10.6%, metastasis 7.3%, primary adrenal malignancy 4% and other rare cases in 11.9%. Laparoscopic adrenalectomy was conducted in 78.8%, open 14.6% and conversion to open in 6.6%. Twenty patients (13.2%) developed postoperative complications including respiratory, urinary, intra-abdominal and wound complications. Postoperative complications were encountered less often in Conn’s syndrome whereas more frequently in primary adrenal malignancy (p=0.04). They were also more often in open and even more in conversions compared to laparoscopic procedures (p<0.001), in malignant cases (p=0.03) and in patients who presented intraoperative complications (p<0.001). Cases with postoperative complications had longer operative time (p=0.01) and hospital stay (p<0.001). No other significant differences were noted.

Post-adrenalectomy complications are not infrequent and significantly lengthen postoperative hospital stay. Patients with malignancy, intraoperative complications, prolonged operative time and open or conversion to open procedure are more likely to suffer from postoperative complications.