Laparoscopic transperitoneal adrenalectomy in morbidly obese patients is not associated with worse short-term outcomes

Int J Urol. 2017 Jan;24(1):59-63. doi: 10.1111/iju.13241. Epub 2016 Oct 12.

Abstract

Objectives: To evaluate the impact of obesity and morbid obesity on short-term outcomes after laparoscopic adrenalectomy.

Methods: The study included 520 consecutive patients undergoing laparoscopic adrenalectomy for adrenal tumor. The entire study group was divided depending on the body mass index: group 1 (normal weight), <25 kg/m2 ; group 2 (overweight), 25-30 kg/m2 ; and group 3 (obese) 30-40 kg/m2 . Additionally, group 4 (morbidly obese) was distinguished. Study end-points were: operative time, intraoperative blood loss, total length of hospital stay, morbidity rate and 30-day readmission rate.

Results: The mean operative times were 88.8, 94.7, 93.5, and 99.9 min in groups 1, 2, 3 and 4, respectively (P = 0.1444). Complications were comparable between groups (12.8% vs 8.8% vs 8.2% vs 11.5%, P = 0.5295). The mean intraoperative blood loss was 66.8 versus 78.3 versus 60.7 versus 92.4, P = 0.1399. There were no differences in conversion rate between groups.

Conclusions: Obesity has no influence on short-term outcomes of laparoscopic transperitoneal adrenalectomy. This procedure is feasible regardless of the body mass index. Therefore, it can be offered to all patient groups including those morbidly obese individuals in whose case preoperative weight loss seems unnecessary.

Keywords: adrenalectomy; incidentaloma; laparoscopy; morbid obesity; pheochromocytoma.

MeSH terms

  • Adrenal Gland Neoplasms / complications
  • Adrenal Gland Neoplasms / surgery*
  • Adrenal Glands / surgery
  • Adrenalectomy / adverse effects*
  • Adrenalectomy / methods
  • Adult
  • Aged
  • Blood Loss, Surgical / statistics & numerical data
  • Body Mass Index
  • Conversion to Open Surgery / statistics & numerical data
  • Feasibility Studies
  • Female
  • Humans
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Obesity, Morbid / complications*
  • Operative Time
  • Peritoneal Cavity / surgery
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome