title: Risk factors for perioperative complications of laparoscopic adrenalectomy including single-site surgery.
abstract: OBJECTIVE
  To determine predictive factors for perioperative complications of laparoscopic adrenalectomy (LA) including single-site surgery performed or supervised by experienced laparoscopic surgeons.
  
  
  METHODS
  We retrospectively reviewed 265 consecutive unilateral LAs performed at a single institution from 2001 to 2011. All surgical procedures were performed or supervised by one of two experienced laparoscopic surgeons. The transabdominal approach was used in 248 patients, while a retroperitoneal approach was used in 17 patients. Laparoendoscopic single-site adrenalectomy was performed in 58 patients. Predictive factors for postoperative complications were analyzed.
  
  
  RESULTS
  There were no postoperative deaths. At least one postoperative complication occurred in 12 (4.6%) patients. No patient underwent reoperation for a complication. Only one (0.4%) patient's procedure was converted to open surgery, and only this patient needed a blood transfusion during the operation. One patient who underwent laparoendoscopic single-site adrenalectomy had the procedure converted to conventional laparoscopic adrenalectomy. Multivariable logistic regression analysis showed that an American Society of Anesthesiologists-physical status grade 3 or above was the only predictive factor for perioperative complications.
  
  
  CONCLUSIONS
  American Society of Anesthesiologists-physical status grade 3 or above was a statistically significant factor for perioperative complications associated with laparoscopic adrenalectomy that involved laparoendoscopic single-site adrenalectomy, which was performed or supervised by an experienced laparoscopic surgeon. According to the findings of this retrospective study, single-site operation, obesity, adrenal tumor size, and tumor type may not be considered as risk factors for perioperative complications after LA performed or supervised by an experienced laparoscopic surgeon.
authors.affiliation: Department of Urology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Seiya
authors.initials: S
authors.lastname: Hattori
authors.forename: Akira
authors.initials: A
authors.lastname: Miyajima
authors.forename: Takahiro
authors.initials: T
authors.lastname: Maeda
authors.forename: Masanori
authors.initials: M
authors.lastname: Hasegawa
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Takeda
authors.forename: Takeo
authors.initials: T
authors.lastname: Kosaka
authors.forename: Eiji
authors.initials: E
authors.lastname: Kikuchi
authors.forename: Ken
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Shibata
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Oya
mesh_terms: D000315:Adrenalectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011183:Postoperative Complications / Q000209:etiology*; D012307:Risk Factors; D013223:Statistics as Topic