Factors affecting operative efficiency and post-operative convalescence in laparoendoscopic single-site (LESS) adrenalectomy

Yao Chou Tsai, Chung Hsien Chen, Ya Hui Hu, Leay Kiaw Er, Che Hsiung Wu, Shih Chieh Chueh, Victor Chia Hsiang Lin

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Laparoendoscopic single-site (LESS) adrenalectomy is a novel challenging technique which is still under clinical evaluation. Initial reports have revealed its superiority in patient convalescence. In addition, it has been reported that some patient or anatomic factors might affect the ergonomics of LESS adrenalectomy. The aim of this study is to investigate the possible factors that might affect procedural efficiency and patient convalescence in LESS adrenalectomy. Methods: Between October 2009 and July 2015, 105 consecutive adult patients with benign adrenal tumors, who underwent LESS retroperitoneal adrenalectomy were enrolled in this study. All the relevant peri-operative parameters were prospectively collected for later analysis. By using stepwise linear regression and stepwise selection of these peri-operative parameters, those that might affect the operative efficiency and patient convalescence were analyzed. Results: Finally, 78 patients who completed follow-up and were eligible for stepwise linear regression were enrolled for final analysis. For parameters affecting operative efficiency, the fitted model revealed that patients with a pre-operative diagnosis of pheochromocytoma, a higher BMI, and an associated co-morbidity of heart disease are associated with a longer operative time. In addition, the fitted model revealed that patients with a lower post-operative pain score, a delayed oral intake, and a diagnosis of non-functioning adrenal tumor were associated with a lengthier period before returning to normal activity. Conclusion: A higher BMI is the only anatomic factor that affects procedural efficiency in LESS adrenalectomy. In addition, post-operative pain score, time to oral intake, and a diagnosis of non-functioning adrenal tumor are the factors affecting patient convalescence.

Original languageEnglish
Pages (from-to)1449-1455
Number of pages7
JournalSurgical endoscopy
Volume32
Issue number3
DOIs
Publication statusPublished - Mar 1 2018
Externally publishedYes

Keywords

  • Adrenalectomy
  • Convalescence
  • Ergonomics
  • LESS

ASJC Scopus subject areas

  • Surgery

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