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Reoperative adrenalectomy: Indications and outcomes
Elizabeth Pace1, Kimberly M Ramonell1, Elizabeth B Habermann2
1University of Pittsburgh, Department of Surgery, UPMC Presbyterian Hospital F1281, 200 Lothrop Street, Division of Endocrine Surgery, Pittsburgh, PA, 15213, USA.
Background:
Reoperative adrenalectomy, defined as subsequent ipsilateral adrenal resection, has been incompletely characterized. Utilizing a multi-institutional database, we investigated the outcomes of reoperative compared to primary adrenalectomy.
Methods:
Using The Collaborative Endocrine Surgery Quality Improvement Program (CESQIP), patients undergoing primary and reoperative adrenalectomy were identified. 30-day outcomes were compared using Chi square and Wilcoxon sum tests.
Results:
Out of 3558 patients, 3469 (97 %) had primary and 89 (3 %) reoperative adrenalectomy. Indications for adrenalectomy varied between groups, p < 0.01. Reoperative adrenalectomy was associated with longer operative time and length of stay, and higher rates of intra-operative complications and readmission. There was no difference in the 30-day mortality rate between the groups.
Conclusions:
Reoperative adrenalectomy is uncommon and is associated with increased morbidity. Patients should be counseled regarding possible operative complications. Although reoperation is associated with an extended length of stay and higher likelihood of readmission, there was no detriment to 30-day mortality.
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