PD3-01 OPEN VERSUS ROBOTIC ADRENALECTOMY – A MATCHED PAIR ANALYSIS

Abstract

You have accessJournal of UrologyAdrenal1 Apr 2015PD3-01 OPEN VERSUS ROBOTIC ADRENALECTOMY – A MATCHED PAIR ANALYSIS Kai Probst, Carsten Ohlmann, Stefan Siemer, Michael Stöckle, and Martin Janssen Kai ProbstKai Probst More articles by this author , Carsten OhlmannCarsten Ohlmann More articles by this author , Stefan SiemerStefan Siemer More articles by this author , Michael StöckleMichael Stöckle More articles by this author , and Martin JanssenMartin Janssen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.288AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Open and laparoscopic adrenalectomies are typically in the domain of general surgeons. However, with the increasing expertise in robotic renal procedures urologists possess a tool that is potentially superior to the classic approaches. We compared a set of open adrenalectomies (OA) to another set of robot-assisted laparoscopic adrenalectomies (RALA) from our institution in a matched pair analysis to show the superiority of the robotic procedure in these patients. METHODS We retrospectively identified a total of 99 adrenalectomies from our department which were performed between February 2001 and May 2014. After eliminating pediatric cases and strictly focussing on those patients who only underwent a single-side adrenalectomy a total of 32 OA and 46 RALA remained. We then categorized these cases by ASA-classification groups (group A=ASA 1,2; group B= ASA 2,3), age (A=<50y, B=>50y), side of surgery and gender and matched them one by one. This left us with 28 pairs of matched patients. RESULTS The 2 groups showed no significant difference in body mass index (=BMI; p=0,419), age (p=0,667), ASA-score (p=0,825) or Charlson comorbidity index (=CCI; p=0,157). The median postoperative drop in hemoglobin (to estimate blood loss) was 1 point for RALA vs. 2 points for OA (p=0,076). Median total hospital stay was 7 days for RALA and 11 days for OA (p<0,001), the median stay on ICU or IMC wards was 1 day for RALA and 2 days for OA (p=0,004). Mean operating time was 102min for OA and 128min for RALA, however, since the RALA procedures contained the learning curve during the introduction of the robot we also looked at the operating times of only the last 10 RALA cases in the series. For these 10 cases, the mean operating time was 95min and thus lower than the mean time for the OA group as well as for the last 10 OA cases from our department (120min). Complications (graded by Clavien-Dindo) occured in n=12 OA cases (n=5 grade 1, n=5 grade 2, n=2 grade 3) and n=5 RALA cases (n=3 grade 1, n=1 grade 2, n=1 grade 3). Blood transfusion was only required in 1 OA case. CONCLUSIONS Our data shows that RALA is better than OA in every aspect; total hospital stay as well as ICU/IMC stay were significantly lower and postoperative hemoglobin drop showed a trend in favor of RALA. Operating time was longer in RALA, however, this might be explained by the learning curve since later procedures showed a lower time than for OA on average. Complications occured much less in RALA procedures. Considering these results adrenal surgery should be in the domain of urologists since RALA is not only a feasible, but overall a superior approach to OA. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e81 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kai Probst More articles by this author Carsten Ohlmann More articles by this author Stefan Siemer More articles by this author Michael Stöckle More articles by this author Martin Janssen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...