Azhar Raed A, Buksh Omar, Alghamdi Musab M, Tayeb Waseem, Subahi Mohnna S, Bakhsh Abdulaziz M, Alkhateeb Sultan S
Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Urology, King Faisal Specialist Hospital, and Research Center, Jeddah, Saudi Arabia.
Saudi J Biol Sci. 2023 Mar;30(3):103575. doi: 10.1016/j.sjbs.2023.103575. Epub 2023 Jan 26.
To determine the nature of adrenal pathology in patients undergoing adrenalectomy in Saudi Arabia over the last decade and compare it with the literature. We compared perioperative outcomes between minimally invasive adrenalectomy (MIA) and open adrenalectomy (OA).
This retrospective study included patients who underwent adrenalectomy at five tertiary care centers in Saudi Arabia from 2010 to 2020. We collected patients' baseline and perioperative characteristics and detailed hormonal evaluation of adrenal masses.
Among 160 patients (mean age 44 ± 14.5 years; mean BMI 29.17 ± 5.96 kg/m), 84 (51.5 %) were men and 51.5 % had left-sided adrenal masses. The mean tumor size was 6.1 ± 4.2 (1.0-19.5) cm, including 60 (37.5 %) incidentalomas and 65 (40.6 %) functioning masses. Histopathology revealed 74 (46.2 %) adenomas and 24 (15 %) cancers or metastases from other primary organs; 20 %, 8.8 %, and 2.5 % of patients had pheochromocytoma, myelolipoma, and 2.5 % ganglioneuroblastoma, respectively. MIA and OA were performed in 135 (84.4 %) and 21 (15.6 %) patients, respectively. Adrenalectomy was increasingly performed over three equal periods in the last decade (17.5 % vs 34.4 % vs 48.1 %), with increasing numbers of MIAs to replace OAs. OA patients had larger tumors and needed blood transfusion more frequently (47.6 % vs 10.8 %, p< 0.001). MIA was significantly associated with shorter operative time, shorter length of stay, and less blood loss. Postoperative complications occurred in 10 (6.2 %) patients and were significantly higher for OA (24 % vs 3.0 %, p< 0.001).
The majority of adrenal masses are benign. Herein, the observed functional and perioperative outcomes were comparable to those of available -analyses.
确定过去十年在沙特阿拉伯接受肾上腺切除术患者的肾上腺病变性质，并与文献进行比较。我们比较了微创肾上腺切除术（MIA）和开放肾上腺切除术（OA）的围手术期结局。
这项回顾性研究纳入了2010年至2020年在沙特阿拉伯五个三级医疗中心接受肾上腺切除术的患者。我们收集了患者的基线和围手术期特征以及肾上腺肿块的详细激素评估。
160例患者（平均年龄44±14.5岁；平均BMI 29.17±5.96kg/m²）中，84例（51.5%）为男性，51.5%有左侧肾上腺肿块。平均肿瘤大小为6.1±4.2（1.0 - 19.5）cm，包括60例（37.5%）偶发瘤和65例（40.6%）功能性肿块。组织病理学显示74例（46.2%）为腺瘤，24例（15%）为癌症或其他原发器官转移瘤；分别有20%、8.8%和2.5%的患者患有嗜铬细胞瘤、髓样脂肪瘤和2.5%的神经母细胞瘤。分别有135例（84.4%）和21例（15.6%）患者接受了MIA和OA。在过去十年中，肾上腺切除术在三个相等时间段内的实施率逐渐增加（17.5%对34.4%对48.1%），MIA的数量增加以取代OA。OA患者的肿瘤更大，输血频率更高（47.6%对10.8%，p<0.001）。MIA与手术时间更短、住院时间更短和失血量更少显著相关。10例（6.2%）患者发生术后并发症，OA患者的并发症发生率显著更高（24%对3.0%，p<0.001）。
大多数肾上腺肿块是良性的。在此，观察到的功能和围手术期结局与现有分析结果相当。
