Association Between Surgical Indication and Outcomes for Outpatient Adrenalectomy

Area of Science:

• Endocrine Surgery
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Inpatient admission after minimally invasive adrenalectomy (MIA) remains common despite a favorable risk-benefit profile.
• Previous research suggests outpatient MIA is safe, but its applicability across different surgical indications requires deeper investigation.

Purpose of the Study:

• To evaluate if the safety of outpatient MIA differs based on the surgical indication for adrenalectomy.
• To compare complication and readmission rates for outpatient versus inpatient MIA across various indications.

Main Methods:

• A retrospective review of 185 patients undergoing MIA from 2012 to 2021.
• Analysis of clinicopathologic parameters, surgical indications, and operative times.
• Comparison of 30-day outcomes (emergency department visits, readmissions, complications) between outpatient and inpatient groups stratified by indication.

Main Results:

• Outpatient MIA was performed in 28.6% of patients and was associated with surgical indication and operative time.
• Pheochromocytoma (PC) patients were less likely to be discharged as outpatients (13.0% vs. 33.8%, P=0.007).
• No significant differences in 30-day complications, ED visits, or readmissions were found between outpatient and inpatient MIA groups (P>0.05).

Conclusions:

• Outpatient MIA demonstrates comparable low complication and readmission rates to inpatient MIA.
• Outpatient MIA is underutilized in patients with PC or longer operative times.
• Selected patients across all adrenal surgery indications may benefit from outpatient MIA.