Endocrine Abstracts

Objectives: To analyze the data of the 22-year-old clinical experience surgical treatment of the adrenal tumor patients in the single specialized endocrinological center.

Materials and methods: There were analyzed the diseases stories of the perioperative period in 1256 patients with adrenal gland tumors who underwent adrenalectomy for the period 1995–2017 in specialized endocrinological center. Average data are given in the format M±σ.

Results: Having analyzed the surgical access, we have been noted that 255 (20.3%) out of total 1256 were performed with open, laparotomic or lumbol-aparotomic access (LTA) operations and 1001 (79.7%) operations were performed using the laparoscopic access (LSA). Among of the total 256 pheochromocytoma patients 81 (31.8%) surgical interventions were performed by using LTA and rest 174 (68.2%) of the operations were performed using the LSA. In terms of gender, men were 334 (26.6%), women – 922 (73.4%), and among patients with the adrenal gland pheochromocytoma – 80 (31.4%) men, 175 (68.6%) women. The average age of the adult patients operated on adrenal glands were 47.7±14.6 years. The average blood loss with LTA was 357.5±192.7 ml, with LSA - 42.2±31.6 ml (significant difference (P=0.012) according to the Wilcoxon test). Total intravenous anesthesia was applied in 93.3% patients with LTA, and in 73.0% of the LSA patients. The inhalative sevoflurane anesthesia was used in 6.7% of LTA patients and in 27.0% of LSA cases (significant difference (P=0.024) according to the Pearson’s chi-square test). The intervention duration was 130.3±46.9 min. and 63.1±19.2 min. with LTA and LSA respectively (significant difference, P=0.013). The duration of inpatient stay in the LSA patients was 7.3±4.9 days, in the LTA patients was 12.3±6.9 days (significant difference, P=0.028). The using of narcotic analgesics in the LTA patients were on average 4.2±2.7 days, in the LSA patients was 1.2±0.9 days (significant difference, P=0.012). The average dose of morphine was 94.5±41.3 mg for LTA interventions, and 24.5±11.3 mg for LSA (significant difference, P=0.021).

Conclusion: Thus, the introduction of laparoscopic methods of surgical intervention for adrenal tumors contributes to a more rapid recovery of patients, a reduction in the hospital stay, accompanied by less blood loss, less expressive pain syndrome.