Kwan Tim Lok, Lam Chi Ming, Yuen Albert W C, Lo Chung Yau
Central Surgical Audit Unit, Hospital Authority, 147B Argyle Street, Kowloon, Hong Kong, China.
Am J Surg. 2007 Aug;194(2):153-8. doi: 10.1016/j.amjsurg.2006.11.030.
A population-based study on adrenal surgery for treatment of adrenal diseases is still lacking. The aim of the present study is to evaluate the practice and the adoption of laparoscopic adrenalectomy (LA) in a stable population, as well as the potential impact of case volume on outcomes.
Patients undergoing elective adrenalectomy (n = 486) from 15 Hong Kong public hospitals over a 6-year period were reviewed. Patients undergoing LA (n = 353) were compared to those undergoing open adrenalectomy (n = 133).
The overall number of adrenalectomies and the number and proportion of laparoscopic approach increased progressively during this period. The median operating time was similar but the median blood loss (50 mL vs 300 mL, P < .01) was less and the mean hospital stay (4.4 days vs 9.4 days) was shorter for LA. Smaller lesions tended to be selected for LA. There was no correlation between postoperative outcome with respect to length of stay and case volume for LA.
The adoption of LA in Hong Kong hospitals was propagating progressively. Patients selected for LA had improved outcome although there seemed to be no significant correlation between postoperative outcome and case volume.
