Robotic and Laparoscopic Adrenalectomy for Pheochromocytoma: An International Multicenter Study.

Autor:	Parente A; Institute of Liver Studies, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK; Department of Hepatopancreatobiliary and Liver Transplant Surgery, Queen Elizabeth Hospital, Birmingham, UK; Department of Surgery, Division of General Surgery, University of Alberta, Edmonton, Alberta, Canada. Electronic address: aleparen@gmail.com., Verhoeff K; Department of Surgery, Division of General Surgery, University of Alberta, Edmonton, Alberta, Canada., Wang Y; Department of Urology, First Affiliated Hospital of Jilin University, Changchun, China., Wang N; Department of Oncology, First Affiliated Hospital of Jilin University, Changchun, China., Wang Z; Department of Urology, First Affiliated Hospital of Jilin University, Changchun, China., Śledziński M; Division of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland., Hellmann A; Division of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Gdańsk, Poland., Raffaelli M; UOC Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Centro di Ricerca in Chirurgia Endocrina e dell'Obesità, Università Cattolica del Sacro Cuore, Rome, Italy., Pennestrì F; UOC Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Centro di Ricerca in Chirurgia Endocrina e dell'Obesità, Università Cattolica del Sacro Cuore, Rome, Italy., Sywak M; Endocrine Surgical Unit, Royal North Shore Hospital, Sydney, Australia., Papachristos AJ; Endocrine Surgical Unit, Royal North Shore Hospital, Sydney, Australia., Palazzo FF; Department of Endocrine Surgery, Hammersmith Hospital, London, UK., Sung TY; Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea., Kim BC; Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea., Lee YM; Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea., Eatock F; Department of Endocrine Surgery, Royal Victoria Hospital, Belfast, UK., Anderson H; Department of Endocrine Surgery, Royal Victoria Hospital, Belfast, UK., Iacobone M; Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy., Daukša A; Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania., Makay O; Centre of Endocrine Surgery, Ozel Saglik Hospital, Izmir, Turkey; School of Medicine, Aristoteleio University of Thessaloniki, Thessaloniki, Greece., Turk Y; Department of General Surgery, Division of Endocrine Surgery, Ege University Hospital, Izmir, Turkey., Basut Atalay H; Department of General Surgery, Division of Endocrine Surgery, Ege University Hospital, Izmir, Turkey., Nieveen van Dijkum EJM; Department of Surgery, Amsterdam UMC, University of Amsterdam Cancer Center, Amsterdam, The Netherlands., Engelsman AF; Department of Surgery, Amsterdam UMC, University of Amsterdam Cancer Center, Amsterdam, The Netherlands., Holscher I; Department of Surgery, Amsterdam UMC, University of Amsterdam Cancer Center, Amsterdam, The Netherlands., Materazzi G; Endocrine Surgery Unit, University Hospital of Pisa, Pisa, Italy., Rossi L; Endocrine Surgery Unit, University Hospital of Pisa, Pisa, Italy., Becucci C; Endocrine Surgery Unit, University Hospital of Pisa, Pisa, Italy., Shore SL; Department of Endocrine and Breast Surgery, Royal Liverpool and Broadgreen University Hospitals Trust, Liverpool, UK., Fung C; Department of Endocrine and Breast Surgery, Royal Liverpool and Broadgreen University Hospitals Trust, Liverpool, UK., Waghorn A; Department of Endocrine and Breast Surgery, Royal Liverpool and Broadgreen University Hospitals Trust, Liverpool, UK., Mihai R; Department of Endocrine Surgery, Churchill Cancer Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Balasubramanian SP; Department of General Surgery, Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK., Pannu A; Department of General Surgery, Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK., Tatarano S; Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan., Velázquez-Fernández D; Servicio de Cirugía Endocrina y Laparoscopia Avanzada, Departamento de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico., Miller JA; Endocrine Surgery Unit, The Royal Melbourne Hospital, Melbourne, Australia., Serrao-Brown H; Endocrine Surgical Unit, Royal North Shore Hospital, Sydney, Australia., Chen Y; Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA., Demarchi MS; Department of Thoracic and Endocrine Surgery and Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland., Djafarrian R; Department of Thoracic and Endocrine Surgery and Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland., Doran H; Department of Endocrine Surgery, Salford Royal Hospital, Salford, UK., Wang K; Department of Endocrine Surgery, Salford Royal Hospital, Salford, UK., Stechman MJ; Department of Endocrine Surgery, University Hospital Wales, Cardiff, UK., Perry H; Department of Endocrine Surgery, University Hospital Wales, Cardiff, UK., Hubbard J; Department of Endocrine Surgery, St. Thomas' Hospital, London, UK., Lamas C; Endocrinology and Nutrition Department. Hospital Universitario de Albacete, Albacete, Spain., Mercer P; Endocrine Surgical Unit, Department of General Surgery, Christchurch Hospital, Christchurch, New Zealand., MacPherson J; Department of Anaesthesia, Christchurch Hospital, Christchurch, New Zealand., Lumbiganon S; Department of Surgery, Division of Urology, Khon Kaen University, Khon Kaen, Thailand., Calatayud M; Endocrinology & Nutrition Department. Hospital Universitario 12 de Octubre. Madrid, Spain., Alexandra Hanzu F; Endocrinology Department, Hospital Clinic de Barcelona, Barcelona, Spain., Vidal O; Endocrine Surgery Department, Hospital Clinic de Barcelona, Barcelona, Spain., Araujo-Castro M; Department of Endocrinology & Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain., Minguez Ojeda C; Urology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain., Papavramidis T; 1st Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece., Rodríguez de Vera Gómez P; Endocrinology and Nutrition Department, Hospital Universitario Virgen de la Macarena, Sevilla, Spain., Aldrees A; King Abdulaziz Medical City, Riyadh, Saudi Arabia., Altwjry T; King Abdulaziz Medical City, Riyadh, Saudi Arabia., Valdés N; Department of Endocrinology and Nutrition, Hospital Universitario Cruces, Barakaldo, Spain., Álvarez-Escola C; Endocrinology and Nutrition Department, Hospital Universitario La Paz, Madrid, Spain., García Sanz I; General & Digestive Surgery Department, Hospital Universitario de La Princesa, Madrid, Spain., Blanco Carrera C; Endocrinology and Nutrition Department, Hospital Universitario Príncipe de Asturias, Madrid, Spain., Manjón-Miguélez L; Endocrinology & Nutrition Department. Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain., De Miguel Novoa P; Hospital Clínico San Carlos, Madrid, Spain., Recasens M; Endocrinology and Nutrition Department, Institut Català de la Salut Girona, Girona, Spain., García Centeno R; Endocrinology and Nutrition Department, Hospital Universitario Gregorio Marañón, Madrid, Spain., Robles Lázaro C; Endocrinology and Nutrition Department, Hospital Universitario de Salamanca, Salamanca, Spain., Van Den Heede K; General and Endocrine Surgery, Onze-Lieve-Vrouw Hospital, Aalst, Belgium., Van Slycke S; General and Endocrine Surgery, Onze-Lieve-Vrouw Hospital, Aalst, Belgium., Michalopoulou T; Department of Endocrinology and Nutrition, Joan XXIII University Hospital, Tarragona, Spain., Aspinall S; Department of General Surgery, Aberdeen Royal Infirmary, Aberdeen, UK., Melvin R; Department of General Surgery, Aberdeen Royal Infirmary, Aberdeen, UK., Lau JWL; Division of Breast and Endocrine Surgery, Department of General Surgery, Ng Teng Fong General Hospital, National University Health System, Singapore., Cheah WK; Division of Breast and Endocrine Surgery, Department of General Surgery, Ng Teng Fong General Hospital, National University Health System, Singapore., Tang MH; Division of Breast and Endocrine Surgery, Department of General Surgery, Ng Teng Fong General Hospital, National University Health System, Singapore., Oh HB; Division of Breast and Endocrine Surgery, Department of General Surgery, Ng Teng Fong General Hospital, National University Health System, Singapore., Ayuk J; Department of Endocrinology, Queen Elizabeth Hospital, Birmingham, UK., Sutcliffe RP; Department of Hepatopancreatobiliary and Liver Transplant Surgery, Queen Elizabeth Hospital, Birmingham, UK.
Jazyk:	angličtina
Zdroj:	European urology focus [Eur Urol Focus] 2024 Sep 14. Date of Electronic Publication: 2024 Sep 14.
DOI:	10.1016/j.euf.2024.09.001
Abstrakt:	Background and Objective: Robotic adrenalectomy (RA) has attracted interest as an alternative to laparoscopic adrenalectomy (LA) for patients with pheochromocytoma, although its beneficial effects are uncertain. Our aim was to compare RA and LA outcomes for these patients. Methods: Data for patients who underwent RA or LA for pheochromocytoma in 46 international centers between 2012 and 2022 were reviewed. We analyzed baseline characteristics and postoperative complications at discharge, 90 d, and 1 yr. We conducted propensity score matching (PSM; 1:1 ratio) and multivariable analyses to evaluate outcomes and risk factors for the occurrence of complications and higher Comprehensive Complication Index (CCI). Key Findings and Limitations: Of 1755 patients, 1613 (91.9%) underwent LA and 142 (8.1%) underwent RA. Estimated blood loss, conversion rate, complication rate, and CCI at discharge, 90 d, and 1 yr were similar between the groups. However, RA was associated with a longer operative time in comparison to LA (100 vs 123 min; p < 0.001), but not after PSM (p = 0.120). Multivariable analysis revealed that Charlson comorbidity index (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.07-1.29; p = 0.001), and tumor size per 1-cm increment (OR 1.13, 95% CI 1.07-1.21; p < 0.001) were independently associated with the incidence of complications, but there was no significant difference in complication rates between the LA and RA groups (OR 1.09, 95% CI 0.63-1.87; p = 0.767). After PSM, RA was associated with a lower rate of severe (grade ≥3a) complications in comparison to LA (p = 0.023). Conclusions and Clinical Implications: RA is a safe alternative to LA and yields similar outcomes for patients with pheochromocytoma. RA may be associated with a lower likelihood of severe complications. Further studies are warranted to determine the role of robotic surgery in pheochromocytoma. Patient Summary: Pheochromocytoma is a rare tumor in the adrenal gland and the gold-standard treatment is surgical removal. We assessed patient outcomes after robot-assisted surgery compared with laparoscopic surgery and found that outcomes are similar, but the rate of severe complications may be lower if a surgical robot is used. (Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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