Adrenalectomy in Hong Kong: a critical review of adoption of laparoscopic approach.
BACKGROUND
A population-based study on adrenal surgery for treatment of adrenal diseases is still lacking. The aim of the present study is to evaluate the practice and the adoption of laparoscopic adrenalectomy (LA) in a stable population, as well as the potential impact of case volume on outcomes.


METHODS
Patients undergoing elective adrenalectomy (n = 486) from 15 Hong Kong public hospitals over a 6-year period were reviewed. Patients undergoing LA (n = 353) were compared to those undergoing open adrenalectomy (n = 133).


RESULTS
The overall number of adrenalectomies and the number and proportion of laparoscopic approach increased progressively during this period. The median operating time was similar but the median blood loss (50 mL vs 300 mL, P < .01) was less and the mean hospital stay (4.4 days vs 9.4 days) was shorter for LA. Smaller lesions tended to be selected for LA. There was no correlation between postoperative outcome with respect to length of stay and case volume for LA.


CONCLUSIONS
The adoption of LA in Hong Kong hospitals was propagating progressively. Patients selected for LA had improved outcome although there seemed to be no significant correlation between postoperative outcome and case volume.
Kwan
Tim Lok
TL
Central Surgical Audit Unit, Hospital Authority, 147B Argyle Street, Kowloon, Hong Kong, China. kwantl@ha.org.hk
Lam
Chi Ming
CM
Yuen
Albert W C
AW
Lo
Chung Yau
CY
D000307:Adrenal Gland Diseases / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods* / Q000706:statistics & numerical data* / Q000639:trends; D000328:Adult; D005260:Female; D006723:Hong Kong; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data* / Q000639:trends; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends; D012189:Retrospective Studies; D018581:Technology Transfer; D016896:Treatment Outcome; D016526:Workload