Adrenalectomy approach and outcomes according to surgeon volume.
Am J Surg
; 229: 44-49, 2024 Mar.
Article
em En
| MEDLINE
| ID: mdl-37940441
ABSTRACT
BACKGROUND:
This study assessed the relationship between surgeon volume, operative management, and resource utilization in adrenalectomy.METHODS:
Isolated adrenalectomies performed within our health system were identified (2016-2021). High-volume surgeons were defined as those performing ≥6 cases/year. Outcomes included indication for surgery, perioperative outcomes, and costs.RESULTS:
Of 476 adrenalectomies, high-volume surgeons (n â= â3) performed 394, while low-volume surgeons (n â= â12) performed 82. High-volume surgeons more frequently operated for pheochromocytoma (19% vs. 16%, p â< â0.001) and less frequently for metastasis (6.4% vs. 23%, p â< â0.001), more frequently used laparoscopy (95% vs. 80%, p â< â0.001), and had lower operative supply costs ($1387 vs. $1,636, p â= â0.037). Additionally, laparoscopic adrenalectomy was associated with shorter length of stay (-3.43 days, p â< â0.001), lower hospitalization costs (-$72,417, p â< â0.001), and increased likelihood of discharge to home (OR 17.03, p â= â0.008).CONCLUSIONS:
High-volume surgeons more often resect primary adrenal pathology and utilize laparoscopy. Laparoscopic adrenalectomy is, in turn, associated with decreased healthcare resource utilization.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Feocromocitoma
/
Laparoscopia
/
Neoplasias das Glândulas Suprarrenais
/
Cirurgiões
Limite:
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article