Abstract：
BACKGROUND:A laparoscopic approach to adrenalectomy has become the procedure of choice for most adrenal resections. We hypothesized that laparoscopic adrenalectomy is less likely to result in intensive care unit (ICU) level complications or death than open adrenalectomy, despite baseline comorbidity mix. METHODS:Using the National Surgical Quality Improvement Program (NSQIP) participant use files for 2005-2009, all laparoscopic and open adrenalectomies were identified by current procedural terminology. Adverse outcomes tracked in NSQIP were mapped to Clavien level based on need for ICU care or death. Univariate and multivariate analysis were used to compare groups. RESULTS:There were 1,980 laparoscopic and 592 open procedures. Clavien 4 and 5 complications occurred in 45 (7.6%) of open and 35 (1.8%) of laparoscopic operations. The univariate odds ratio showed a 4.6-fold greater likelihood that a patient would have an ICU level complication (P < .001), and 4.9 odds ratio of death (P < .001) if an open rather than laparoscopic operation was performed. Regression modeling showed persistence of the protective effect of laparoscopy after adjusting for comorbidities with a multivariate odds ratio of 3.3 (P < .001). CONCLUSION:The laparoscopic approach to adrenalectomy has an independent protective effect on ICU level complications and mortality when compared with open procedures. This correlation persists after correcting for multiple comorbidities.
journal_name
Surgeryjournal_title
Surgeryauthors
Eichhorn-Wharry LI,Talpos GB,Rubinfeld Idoi
10.1016/j.surg.2012.08.020subject
Has Abstractpub_date
2012-12-01 00:00:00pages
1090-5issue
6eissn
0039-6060issn
1532-7361pii
S0039-6060(12)00471-0journal_volume
152pub_type
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