Rossi Leonardo, Becucci Chiara, Della Posta Ortensia, Papini Piermarco, Palma Francesca, Cammarata Mattia, Sacco Luisa, Dekova Klaudiya, Ajdini Suela, Ambrosini Carlo Enrico, Materazzi Gabriele
Endocrine Surgery Unit, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56122 Pisa, Italy.
J Clin Med. 2025 Jul 22;14(15):5176. doi: 10.3390/jcm14155176.
: The suitability of minimally invasive adrenalectomy (MIA) for adrenal tumors ≥6 cm remains debated due to technical challenges and oncological concerns. This study aimed to assess the safety and feasibility of MIA for large adrenal tumors by comparing surgical outcomes with smaller tumors. : This retrospective cohort study included 269 patients who underwent MIA (2013-2023), divided into two groups: Group A (<6 cm, n = 197) and Group B (≥6 cm, n = 72). The primary endpoint was the postoperative complication rate; secondary endpoints included conversion to open surgery and postoperative length of stay (LOS). : Multivariate analysis identified no factors associated with postoperative complications; however, tumor size ≥ 6 cm was associated with conversion to open surgery ( = 0.031). Bilateral procedures and a higher Charlson comorbidity index were associated with longer LOS ( < 0.001 and = 0.015, respectively). : MIA is a safe and feasible approach for tumors ≥6 cm, despite being associated with a higher conversion rate.
由于技术挑战和肿瘤学方面的担忧，对于直径≥6 cm的肾上腺肿瘤，微创肾上腺切除术（MIA）的适用性仍存在争议。本研究旨在通过比较大肾上腺肿瘤与较小肿瘤的手术结果，评估MIA治疗大肾上腺肿瘤的安全性和可行性。：这项回顾性队列研究纳入了269例行MIA的患者（2013 - 2023年），分为两组：A组（<6 cm，n = 197）和B组（≥6 cm，n = 72）。主要终点是术后并发症发生率；次要终点包括转为开放手术和术后住院时间（LOS）。：多因素分析未发现与术后并发症相关的因素；然而，肿瘤大小≥6 cm与转为开放手术相关（P = 0.031）。双侧手术和较高的Charlson合并症指数与较长的LOS相关（分别为P < 0.001和P = 0.015）。：尽管MIA的转化率较高，但对于≥6 cm的肿瘤，它是一种安全可行的方法。
