Abstract:
Background Open adrenalectomy is an invasive surgical procedure that is commonly performed for adrenal gland neoplasms in developing countries. Due to its complexity, the patients are predisposed to a number of complications and dismal outcomes. The objective of our study is to assess different characteristics of patients undergoing open adrenalectomy, including their histology, postoperative complications, and outcomes. Methods This retrospective cross-sectional study included 107 patients undergoing open adrenalectomy for primary adrenal gland neoplasms. Patients with bilateral involvement, metastatic disease, or unresectable tumors were excluded. Patients were evaluated for different features that included demographic data, tumor properties, postoperative outcomes, and complications. Results Out of 107 patients, 45 (42.1%) were females. The mean age of the patients was 47.53 ± 8.45 years. Abdominal pain and severe headaches were the most common presenting complaints. A total of 96 (89.7%) tumors were benign, while 11 (10.3%) were malignant. Upon the histopathological examination of the resected specimen, adrenal adenoma was present in 49 (45.8%) cases, while adrenal pheochromocytoma was present in 41 (38.3%) cases. A total of 51 patients developed different postoperative complications including surgical site infections (22.4%), atelectasis (11.2%), deep venous thrombosis (7.5%), and retroperitoneal hematoma (5.6%). In-hospital mortality occurred in three (2.8%) patients. Conclusion Surgical site infections, atelectasis, deep venous thrombosis, and retroperitoneal hematoma were frequent postoperative complications after open adrenalectomy. These complications increase morbidity and mortality, especially in developing countries. Improved surgical techniques, intraoperative hemostasis, and multidisciplinary approach can yield favorable postoperative outcomes.
摘要:
背景技术开放性肾上腺切除术是一种侵入性外科手术,在发展中国家通常用于肾上腺肿瘤。由于其复杂性,患者容易出现一些并发症和令人沮丧的结果.我们研究的目的是评估开放性肾上腺切除术患者的不同特征,包括他们的组织学,术后并发症,和结果。方法本回顾性横断面研究包括107例原发性肾上腺肿瘤开放性肾上腺切除术患者。双侧受累的患者,转移性疾病,或无法切除的肿瘤被排除。评估患者的不同特征,包括人口统计数据,肿瘤特性,术后结果,和并发症。结果107例患者中,45名(42.1%)为女性。患者的平均年龄为47.53±8.45岁。腹痛和严重头痛是最常见的主诉。共有96个(89.7%)肿瘤是良性的,11例(10.3%)为恶性。在对切除的标本进行组织病理学检查后,49例(45.8%)存在肾上腺腺瘤,肾上腺嗜铬细胞瘤41例(38.3%)。共有51例患者出现不同的术后并发症,包括手术部位感染(22.4%),肺不张(11.2%),深静脉血栓形成(7.5%),腹膜后血肿(5.6%)。3例(2.8%)患者发生院内死亡。结论手术部位感染,肺不张,深静脉血栓形成,腹膜后血肿是开放肾上腺切除术后常见的并发症。这些并发症增加了发病率和死亡率,尤其是在发展中国家。改进的手术技术,术中止血,多学科方法可以产生良好的术后结局。