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Annals of Surgical Oncology

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01-11-2021 | Adrenal Cancer | Endocrine Tumors

Robotic Posterior Retroperitoneal Adrenalectomy: Patient Selection and Long-Term Outcomes

Authors: Mehmet Gokceimam, MD, Bora Kahramangil, MD, Serkan Akbulut, MD, Ozgun Erten, MD, Eren Berber, MD, MBA

Published in: Annals of Surgical Oncology | Issue 12/2021

Abstract

Background

Recently, efficacy of laparoscopic posterior retroperitoneal adrenalectomy (PRA) for pheochromocytoma and malignancy has been questioned. Although robotic technique using wristed instruments may improve limitations of laparoscopic PRA, the worldwide experience with robotic PRA is limited. This study aimed to describe patient characteristics, surgical technique, and long-term outcomes of robotic PRA from a 12-year single-center experience.

Methods

This analysis was an institutional review board-approved retrospective study. In this study, PRA was performed robotically, with intraoperative ultrasound and indocyanine green imaging guidance. Long-term outcomes and predictors of operative time (OT) were assessed using descriptive and regression analyses. Using OT as a surrogate for difficulty of procedure, receiver operating characteristic curve analysis was performed to quantify anthropometric thresholds that would predict a more challenging procedure.

Results

Altogether, 112 robotic PRA procedures were performed. Three cases (3%) were converted to a lateral approach, and one case (1%) was converted to open surgery. The morbidity rate was 2%. Microscopic capsular disruption occurred for one patient. No patient experienced persistent disease or local recurrence from pheochromocytoma or malignant adrenal tumors during the follow-up period (median, 48 months). Operating time was independently predicted by perirenal fat thickness, with 18.5 mm as the critical threshold.

Conclusion

In this study, favorable PRA outcomes were achieved with careful patient selection and meticulous surgical technique that used robotic articulation guided by intraoperative imaging.

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Title: Robotic Posterior Retroperitoneal Adrenalectomy: Patient Selection and Long-Term Outcomes
Authors: Mehmet Gokceimam, MD
Bora Kahramangil, MD
Serkan Akbulut, MD
Ozgun Erten, MD
Eren Berber, MD, MBA
Publication date: 01-11-2021
Publisher: Springer International Publishing
Keywords: Adrenal Cancer
Adrenalectomy
Adrenal Cancer
Adrenalectomy
Published in: Annals of Surgical Oncology / Issue 12/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-021-10088-w

2024 ASCO Annual Meeting

Springer Medicine

Robotic Posterior Retroperitoneal Adrenalectomy: Patient Selection and Long-Term Outcomes

Abstract

Background

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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