Impact of novel techniques on minimally invasive adrenal surgery

trends and outcomes from a contemporary international large series in urology

Nicola Pavan, Riccardo Autorino, Hak Lee, Francesco Porpiglia, Yinghao Sun, Francesco Greco, S. Jeff Chueh, Deok Hyun Han, Luca Cindolo, Matteo Ferro, Xiang Chen, Anibal Branco, Paolo Fornara, Chun Hou Liao, Akira Miyajima, Iason Kyriazis, Marco Puglisi, Cristian Fiori, Bo Yang, Guo Fei & 14 others Vincenzo Altieri, Byong Chang Jeong, Francesco Berardinelli, Luigi Schips, Ottavio de Cobelli, Zhi Chen, Georges Pascal Haber, Yao He, Mototsugu Oya, Evangelos Liatsikos, Luis Brandao, Benjamin Challacombe, Jihad Kaouk, Ithaar Darweesh

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: To evaluate contemporary international trends in the implementation of minimally invasive adrenalectomy and to assess contemporary outcomes of different minimally invasive techniques performed at urologic centers worldwide. Methods: A retrospective multinational multicenter study of patients who underwent minimally invasive adrenalectomy from 2008 to 2013 at 14 urology institutions worldwide was included in the analysis. Cases were categorized based on the minimally invasive adrenalectomy technique: conventional laparoscopy (CL), robot-assisted laparoscopy (RAL), laparoendoscopic single-site surgery (LESS), and mini-laparoscopy (ML). The rates of the four treatment modalities were determined according to the year of surgery, and a regression analysis was performed for trends in all surgical modalities. Results: Overall, a total of 737 adrenalectomies were performed across participating institutions and included in this analysis: 337 CL (46 % of cases), 57 ML (8 %), 263 LESS (36 %), and 80 RA (11 %). Overall, 204 (28 %) operations were performed with a retroperitoneal approach. The overall number of adrenalectomies increased from 2008 to 2013 (p = 0.05). A transperitoneal approach was preferred in all but the ML group (p <0.001). European centers mostly adopted CL and ML techniques, whereas those from Asia and South America reported the highest rate in LESS procedures, and RAL was adopted to larger extent in the USA. LESS had the fastest increase in utilization at 6 %/year. The rate of RAL procedures increased at slower rates (2.2 %/year), similar to ML (1.7 %/year). Limitations of this study are the retrospective design and the lack of a cost analysis. Conclusions: Several minimally invasive surgical techniques for the management of adrenal masses are successfully implemented in urology institutions worldwide. CL and LESS seem to represent the most commonly adopted techniques, whereas ML and RAL are growing at a slower rate. All the MIS techniques can be safely and effectively performed for a variety of adrenal disease.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalWorld Journal of Urology
DOIs
Publication statusAccepted/In press - 2016 Feb 29

Fingerprint

Minimally Invasive Surgical Procedures
Urology
Laparoscopy
Adrenalectomy
South America
Multicenter Studies

Keywords

  • Adrenalectomy
  • Laparoscopy
  • LESS
  • Minimally invasive
  • Outcomes
  • Robotic

ASJC Scopus subject areas

  • Urology

Cite this

Impact of novel techniques on minimally invasive adrenal surgery : trends and outcomes from a contemporary international large series in urology. / Pavan, Nicola; Autorino, Riccardo; Lee, Hak; Porpiglia, Francesco; Sun, Yinghao; Greco, Francesco; Jeff Chueh, S.; Han, Deok Hyun; Cindolo, Luca; Ferro, Matteo; Chen, Xiang; Branco, Anibal; Fornara, Paolo; Liao, Chun Hou; Miyajima, Akira; Kyriazis, Iason; Puglisi, Marco; Fiori, Cristian; Yang, Bo; Fei, Guo; Altieri, Vincenzo; Jeong, Byong Chang; Berardinelli, Francesco; Schips, Luigi; de Cobelli, Ottavio; Chen, Zhi; Haber, Georges Pascal; He, Yao; Oya, Mototsugu; Liatsikos, Evangelos; Brandao, Luis; Challacombe, Benjamin; Kaouk, Jihad; Darweesh, Ithaar.

In: World Journal of Urology, 29.02.2016, p. 1-7.

Research output: Contribution to journalArticle

Pavan, N, Autorino, R, Lee, H, Porpiglia, F, Sun, Y, Greco, F, Jeff Chueh, S, Han, DH, Cindolo, L, Ferro, M, Chen, X, Branco, A, Fornara, P, Liao, CH, Miyajima, A, Kyriazis, I, Puglisi, M, Fiori, C, Yang, B, Fei, G, Altieri, V, Jeong, BC, Berardinelli, F, Schips, L, de Cobelli, O, Chen, Z, Haber, GP, He, Y, Oya, M, Liatsikos, E, Brandao, L, Challacombe, B, Kaouk, J & Darweesh, I 2016, 'Impact of novel techniques on minimally invasive adrenal surgery: trends and outcomes from a contemporary international large series in urology', World Journal of Urology, pp. 1-7. https://doi.org/10.1007/s00345-016-1791-9
Pavan, Nicola ; Autorino, Riccardo ; Lee, Hak ; Porpiglia, Francesco ; Sun, Yinghao ; Greco, Francesco ; Jeff Chueh, S. ; Han, Deok Hyun ; Cindolo, Luca ; Ferro, Matteo ; Chen, Xiang ; Branco, Anibal ; Fornara, Paolo ; Liao, Chun Hou ; Miyajima, Akira ; Kyriazis, Iason ; Puglisi, Marco ; Fiori, Cristian ; Yang, Bo ; Fei, Guo ; Altieri, Vincenzo ; Jeong, Byong Chang ; Berardinelli, Francesco ; Schips, Luigi ; de Cobelli, Ottavio ; Chen, Zhi ; Haber, Georges Pascal ; He, Yao ; Oya, Mototsugu ; Liatsikos, Evangelos ; Brandao, Luis ; Challacombe, Benjamin ; Kaouk, Jihad ; Darweesh, Ithaar. / Impact of novel techniques on minimally invasive adrenal surgery : trends and outcomes from a contemporary international large series in urology. In: World Journal of Urology. 2016 ; pp. 1-7.
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abstract = "Objective: To evaluate contemporary international trends in the implementation of minimally invasive adrenalectomy and to assess contemporary outcomes of different minimally invasive techniques performed at urologic centers worldwide. Methods: A retrospective multinational multicenter study of patients who underwent minimally invasive adrenalectomy from 2008 to 2013 at 14 urology institutions worldwide was included in the analysis. Cases were categorized based on the minimally invasive adrenalectomy technique: conventional laparoscopy (CL), robot-assisted laparoscopy (RAL), laparoendoscopic single-site surgery (LESS), and mini-laparoscopy (ML). The rates of the four treatment modalities were determined according to the year of surgery, and a regression analysis was performed for trends in all surgical modalities. Results: Overall, a total of 737 adrenalectomies were performed across participating institutions and included in this analysis: 337 CL (46 {\%} of cases), 57 ML (8 {\%}), 263 LESS (36 {\%}), and 80 RA (11 {\%}). Overall, 204 (28 {\%}) operations were performed with a retroperitoneal approach. The overall number of adrenalectomies increased from 2008 to 2013 (p = 0.05). A transperitoneal approach was preferred in all but the ML group (p <0.001). European centers mostly adopted CL and ML techniques, whereas those from Asia and South America reported the highest rate in LESS procedures, and RAL was adopted to larger extent in the USA. LESS had the fastest increase in utilization at 6 {\%}/year. The rate of RAL procedures increased at slower rates (2.2 {\%}/year), similar to ML (1.7 {\%}/year). Limitations of this study are the retrospective design and the lack of a cost analysis. Conclusions: Several minimally invasive surgical techniques for the management of adrenal masses are successfully implemented in urology institutions worldwide. CL and LESS seem to represent the most commonly adopted techniques, whereas ML and RAL are growing at a slower rate. All the MIS techniques can be safely and effectively performed for a variety of adrenal disease.",
keywords = "Adrenalectomy, Laparoscopy, LESS, Minimally invasive, Outcomes, Robotic",
author = "Nicola Pavan and Riccardo Autorino and Hak Lee and Francesco Porpiglia and Yinghao Sun and Francesco Greco and {Jeff Chueh}, S. and Han, {Deok Hyun} and Luca Cindolo and Matteo Ferro and Xiang Chen and Anibal Branco and Paolo Fornara and Liao, {Chun Hou} and Akira Miyajima and Iason Kyriazis and Marco Puglisi and Cristian Fiori and Bo Yang and Guo Fei and Vincenzo Altieri and Jeong, {Byong Chang} and Francesco Berardinelli and Luigi Schips and {de Cobelli}, Ottavio and Zhi Chen and Haber, {Georges Pascal} and Yao He and Mototsugu Oya and Evangelos Liatsikos and Luis Brandao and Benjamin Challacombe and Jihad Kaouk and Ithaar Darweesh",
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T1 - Impact of novel techniques on minimally invasive adrenal surgery

T2 - trends and outcomes from a contemporary international large series in urology

AU - Pavan, Nicola

AU - Autorino, Riccardo

AU - Lee, Hak

AU - Porpiglia, Francesco

AU - Sun, Yinghao

AU - Greco, Francesco

AU - Jeff Chueh, S.

AU - Han, Deok Hyun

AU - Cindolo, Luca

AU - Ferro, Matteo

AU - Chen, Xiang

AU - Branco, Anibal

AU - Fornara, Paolo

AU - Liao, Chun Hou

AU - Miyajima, Akira

AU - Kyriazis, Iason

AU - Puglisi, Marco

AU - Fiori, Cristian

AU - Yang, Bo

AU - Fei, Guo

AU - Altieri, Vincenzo

AU - Jeong, Byong Chang

AU - Berardinelli, Francesco

AU - Schips, Luigi

AU - de Cobelli, Ottavio

AU - Chen, Zhi

AU - Haber, Georges Pascal

AU - He, Yao

AU - Oya, Mototsugu

AU - Liatsikos, Evangelos

AU - Brandao, Luis

AU - Challacombe, Benjamin

AU - Kaouk, Jihad

AU - Darweesh, Ithaar

PY - 2016/2/29

Y1 - 2016/2/29

N2 - Objective: To evaluate contemporary international trends in the implementation of minimally invasive adrenalectomy and to assess contemporary outcomes of different minimally invasive techniques performed at urologic centers worldwide. Methods: A retrospective multinational multicenter study of patients who underwent minimally invasive adrenalectomy from 2008 to 2013 at 14 urology institutions worldwide was included in the analysis. Cases were categorized based on the minimally invasive adrenalectomy technique: conventional laparoscopy (CL), robot-assisted laparoscopy (RAL), laparoendoscopic single-site surgery (LESS), and mini-laparoscopy (ML). The rates of the four treatment modalities were determined according to the year of surgery, and a regression analysis was performed for trends in all surgical modalities. Results: Overall, a total of 737 adrenalectomies were performed across participating institutions and included in this analysis: 337 CL (46 % of cases), 57 ML (8 %), 263 LESS (36 %), and 80 RA (11 %). Overall, 204 (28 %) operations were performed with a retroperitoneal approach. The overall number of adrenalectomies increased from 2008 to 2013 (p = 0.05). A transperitoneal approach was preferred in all but the ML group (p <0.001). European centers mostly adopted CL and ML techniques, whereas those from Asia and South America reported the highest rate in LESS procedures, and RAL was adopted to larger extent in the USA. LESS had the fastest increase in utilization at 6 %/year. The rate of RAL procedures increased at slower rates (2.2 %/year), similar to ML (1.7 %/year). Limitations of this study are the retrospective design and the lack of a cost analysis. Conclusions: Several minimally invasive surgical techniques for the management of adrenal masses are successfully implemented in urology institutions worldwide. CL and LESS seem to represent the most commonly adopted techniques, whereas ML and RAL are growing at a slower rate. All the MIS techniques can be safely and effectively performed for a variety of adrenal disease.

AB - Objective: To evaluate contemporary international trends in the implementation of minimally invasive adrenalectomy and to assess contemporary outcomes of different minimally invasive techniques performed at urologic centers worldwide. Methods: A retrospective multinational multicenter study of patients who underwent minimally invasive adrenalectomy from 2008 to 2013 at 14 urology institutions worldwide was included in the analysis. Cases were categorized based on the minimally invasive adrenalectomy technique: conventional laparoscopy (CL), robot-assisted laparoscopy (RAL), laparoendoscopic single-site surgery (LESS), and mini-laparoscopy (ML). The rates of the four treatment modalities were determined according to the year of surgery, and a regression analysis was performed for trends in all surgical modalities. Results: Overall, a total of 737 adrenalectomies were performed across participating institutions and included in this analysis: 337 CL (46 % of cases), 57 ML (8 %), 263 LESS (36 %), and 80 RA (11 %). Overall, 204 (28 %) operations were performed with a retroperitoneal approach. The overall number of adrenalectomies increased from 2008 to 2013 (p = 0.05). A transperitoneal approach was preferred in all but the ML group (p <0.001). European centers mostly adopted CL and ML techniques, whereas those from Asia and South America reported the highest rate in LESS procedures, and RAL was adopted to larger extent in the USA. LESS had the fastest increase in utilization at 6 %/year. The rate of RAL procedures increased at slower rates (2.2 %/year), similar to ML (1.7 %/year). Limitations of this study are the retrospective design and the lack of a cost analysis. Conclusions: Several minimally invasive surgical techniques for the management of adrenal masses are successfully implemented in urology institutions worldwide. CL and LESS seem to represent the most commonly adopted techniques, whereas ML and RAL are growing at a slower rate. All the MIS techniques can be safely and effectively performed for a variety of adrenal disease.

KW - Adrenalectomy

KW - Laparoscopy

KW - LESS

KW - Minimally invasive

KW - Outcomes

KW - Robotic

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