CLINICAL OUTCOMES OF ADRENALECTOMY IN A RESOURCE-LIMITED SETTING: PREDICTORS OF COMPLICATIONS AND SURGICAL CHALLENGES alameenalnoor13@gmail.com

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CLINICAL OUTCOMES OF ADRENALECTOMY IN A RESOURCE-LIMITED SETTING: PREDICTORS OF COMPLICATIONS AND SURGICAL CHALLENGES

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Yemen

Oral or Poster

Adrenalectomy is the definitive treatment for adrenal tumors, performed via open or laparoscopic approaches based on tumor characteristics. However, limited data are available from developing countries, especially in the Middle East. This study aimed to assess the clinical presentation, tumor characteristics, surgical approaches, and outcomes of adrenalectomy in a resource-limited setting.

A prospective descriptive study was conducted on 43 patients who underwent adrenalectomy at tertiary hospitals in Yemen between January 2020 and April 2025. Data on demographics, tumor features, surgical details, and postoperative outcomes were analyzed using SPSS v20, with significance set at p < 0.05.

A total of 49 procedures were performed. The mean patient age was 29.5 ± 15.4 years; 65.1% were female. Hypertension (48.8%) was the most common symptom. Functional tumors represented 65.1% of cases, with pheochromocytoma being most frequent (48.8%). Open adrenalectomy was performed in 88.4% of patients, primarily due to larger tumors, while laparoscopic surgery (11.6%) was reserved for smaller tumors (4.5 ± 1.2 cm) and was associated with shorter hospital stays (4 ± 1 days vs. 7 ± 2 days; p < 0.001). Malignancy was found in 16.3% of cases, all >6 cm. Complications occurred in 16.3%, and mortality was 2.3%.

Open adrenalectomy remains predominant in Yemen due to late presentation and limited laparoscopic resources. Laparoscopic surgery offers clear benefits for smaller tumors. Enhancing laparoscopic training and infrastructure is essential to improve outcomes in similar settings. Further large-scale studies are recommended.