title: Laparoscopic adrenalectomy: auditing the 10 year experience of a single centre.
abstract: BACKGROUND
  Laparoscopic adrenalectomy (LA) is the gold standard for benign adrenal resection, and has been performed at our centre since 2000. We present a retrospective audit of our ten-year experience, and discuss the learning curve.
  
  
  METHODS
  Creating a retrospective database, clinical and outcome data were collected for all resections performed over a ten-year period (2000-2010). Patients were chronologically divided into an 'early' (first 40 cases) and 'late' (subsequent cases) group to provide an insight into the learning curve.
  
  
  RESULTS
  Over this period, 134 laparoscopic resections were performed, predominantly for benign adenomas (80.3%), with 48% of patients having primary hyperaldosteronism. There was almost equal sex distribution and mean age was 50.2 years, with a median BMI of 28.2. The mean operating time for left and right procedures were 127 and 124 min respectively, with 56.7% of resections being left sided. Our rate of conversion to open was 3.9%. Median length of stay was 4 days post-operatively. There was no mortality and 8.7% patients experienced a surgical complication. Analysis of the grouped data demonstrated a statistically significant reduction in open conversion rate (p = 0.017) and operative time (p = 0.011) in the 'late' group. Among the two groups there was no statistically significant difference in the length of stay and surgical complication rate. All results were comparable to published series in the literature.
  
  
  CONCLUSIONS
  LA has proven to be a safe procedure with a low complication rate at our centre. Our data provide evidence that operative time and conversion rate improves with experience.
authors.affiliation: Department of Surgery (Box 202), Cambridge University Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom. ja297@cam.ac.uk
authors.forename: Jason M
authors.initials: JM
authors.lastname: Ali
authors.forename: Siong-Seng
authors.initials: SS
authors.lastname: Liau
authors.forename: Kevin
authors.initials: K
authors.lastname: Gunning
authors.forename: Asif
authors.initials: A
authors.lastname: Jah
authors.forename: Emmanuel L
authors.initials: EL
authors.lastname: Huguet
authors.forename: Raaj K
authors.initials: RK
authors.lastname: Praseedom
authors.forename: Neville V
authors.initials: NV
authors.lastname: Jamieson
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D059032:Learning Curve; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery*; D055815:Young Adult