Department of Urology, Bursa Uludag University, Gorukle Campus, Bursa, 16059, Turkey.
Department of Endocrinology, Bursa Uludag University, Gorukle Campus, Bursa, 16059, Turkey.
Langenbecks Arch Surg. 2024 Jul 10;409(1):212. doi: 10.1007/s00423-024-03409-6.
This study aimed to determine the effect of adrenal mass functionality and different hormone subtypes synthesized by the adrenal masses on laparoscopic adrenalectomy (LA) outcomes.
The study included 298 patients, 154 of whom were diagnosed with nonfunctional masses. In the functional group, 33, 62, and 59 patients had Conn syndrome, Cushing's syndrome, and pheochromocytoma, respectively. The variables were analyzed between the functional and nonfunctional groups and then compared among functional masses through subgroup analysis.
The incidence of diabetes mellitus, hypertension, and obesity, blood loss, and length of hospital stay (LOH) were significantly higher in the functional group than in the nonfunctional group. In the subgroup analysis, patients with pheochromocytoma had significantly lower body mass index but significantly higher mass size, blood loss, and LOH than the other two groups. A positive correlation was found between mass size and blood loss in patients with pheochromocytoma (p ≤ 0.001, r = 0.761). However, no significant difference in complications was found among the groups.
In this study, patients with functional adrenal masses had higher comorbidity rates and American Society of Anesthesiologists scores. Moreover, blood loss and LOH were longer on patients with functional adrenal masses who underwent LA. Mass size, blood loss, and LOH in patients with pheochromocytoma were significantly longer than those in patients with other functional adrenal masses. Thus, mass functionality did not increase the complications.
本研究旨在确定肾上腺肿块功能以及由肾上腺肿块合成的不同激素亚型对腹腔镜肾上腺切除术（LA）结果的影响。
该研究纳入了 298 名患者，其中 154 名被诊断为无功能性肿块。在功能性组中，分别有 33、62 和 59 名患者患有Conn 综合征、库欣综合征和嗜铬细胞瘤。对功能性和非功能性组之间的变量进行了分析，然后通过亚组分析对功能性肿块进行了比较。
功能性组的糖尿病、高血压和肥胖症、出血量和住院时间（LOH）的发生率明显高于非功能性组。在亚组分析中，与其他两组相比，患有嗜铬细胞瘤的患者体重指数明显较低，但肿块大小、出血量和 LOH 明显较高。嗜铬细胞瘤患者的肿块大小与出血量之间存在正相关（p≤0.001，r=0.761）。然而，各组之间的并发症无显著差异。
在这项研究中，功能性肾上腺肿块患者的合并症发生率和美国麻醉医师协会评分较高。此外，功能性肾上腺肿块患者接受 LA 时出血量和 LOH 较长。与其他功能性肾上腺肿块患者相比，患有嗜铬细胞瘤的患者的肿块大小、出血量和 LOH 明显更长。因此，肿块功能并未增加并发症。
