Outpatient laparoscopic adrenalectomy: a new step ahead

Abstract

The feasibility of performing laparoscopic adrenalectomy (LA) as an outpatient procedure in selected patients in the context of a specialized unit has been assessed in this study. Retrospective cohort of 22 patients who underwent LA without hospital admission under strict selection criteria within a specific laparoscopic surgery unit of a tertiary hospital center has been reported. Patient demographics, indications for surgery, operative data, outpatient management, morbidity, and immediate follow-up have been analyzed. The mean age of the patients was 50.9 years (median 52.5, range 28-65) and 13 (59.1%) were women. All patients underwent successful LA and none of them required conversion to laparotomy. The mean length of the procedure was 56.6 min (median 60, range 15-120 min) and no patient required transfusion. The most common indications for surgery were adrenal incidentaloma and primary hyperaldosteronism (36.4% each). Three patients accurately complied with the MAS regimen and the other 19 spent the night on a DC basis and were discharged with the hospital stay being less than 23 h. No patient required readmission and relevant events occurred only in three patients. With regard to postoperative pain management, only six patients (27.27%) required more than 1 week of analgesics. In 68.1% of the cases, resuming physical and professional activity took less than 2 weeks and only three patients required more than 1 month before restoring a "normal life." By applying strict protocol and selection criteria, LA can be safely and successfully performed as an outpatient procedure within an experienced laparoscopic unit.