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JA Forster, R Sandhu, CS Biyani, AJ Browning Department of Urology

Audit of 14 years experience of Laparoscopic Adrenalectomy using the Uro-Clavien-Dindo classification of complications. JA Forster, R Sandhu, CS Biyani, AJ Browning Department of Urology. Laparoscopic Adrenalectomy. First reported in 1992. Uncommon.

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JA Forster, R Sandhu, CS Biyani, AJ Browning Department of Urology

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  1. Audit of 14 years experience of Laparoscopic Adrenalectomy using the Uro-Clavien-Dindo classification of complications JAForster, R Sandhu, CS Biyani, AJ Browning Department of Urology

  2. Laparoscopic Adrenalectomy • First reported in 1992. Uncommon. • Laparoscopic surgery is favourable due to: • Small size of adrenals • Difficulty in reaching with open surgery • Benign nature of most masses • Indications include: • Phaeochromocytoma (endocrinology/anaesthetists) • Cushing’s • Conn’s • Adrenal carcinoma

  3. Results (1) • 31 patients had a lap. adrenalectomy over 14 yrs. • The mean age was 53. • The most common presentations were: • Mean size of lesion (pre-op) was 4.5cm. • 7 patients had raised pre-op urinary catecholamines • Mean operative time was 168 mins. 3 pts Tx • 11 received pre/intra-operative Magnesium infusion.

  4. Results (2) and Conclusions • Median hospital stay was 5 days. • Complications classified using Uro-Clavien-Dindo: • Grade I (e.g. ileus): None • Grade II: 8 in 6 pts (infection (4), blood Tx (3)) • Grade IIIa (intervention under L.A.): None • Grade IIIb: Two (both conversion to open) • Grade IVa (1 organ failure): 2; Gr. IVb (multi): 0 • Grade V (death): None • Histopathology: 14 adenoma, 10 Phaeo, others • Laparoscopic adrenalectomy can be safely performed in this district general hospital setting

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