title: Complications associated with laparoscopic adrenalectomy: Description and standardized assessment.
abstract: OBJECTIVE
  Laparoscopic adrenalectomy (LA) is the procedure of choice for surgical management of the adrenal masses. Our objective is to show a standardized assessment of perioperative complications in one LA series.
  
  
  METHODS
  322 LA were performed consecutively between June of 1993 and September of 2012 in patients diagnosed with suprarenal tumour. In order to evaluate perioperative complications, data were collected prospectively and analysed retrospectively. Intraoperative complications were defined using Satava classification and Clavien-Dindo classification of postoperative complications.
  
  
  RESULTS
  Twenty five LA showed perioperative complications (7.3%); 11 (3.2%) were intraoperative complications, most of them vascular diaphragmatic lesions (Satava Grade 2); and 14 (4.1%) were postoperative complications. Six patients showed complications requiring surgery (Clavien IIIa/IIIb) and/or support in Intensive Care Unit (Clavien IV). Conversion to open surgery was necessary in one case (.3%). Despite all appropriate preoperative endocrine measures were taken, an uncontrolled hypertensive crisis and cardio-respiratory arrest recovered were developed during surgery in one patient carrier of pheochromocytoma who died from massive cerebral infarction at 5 days (Clavien V).
  
  
  CONCLUSIONS
  Standardized criteria of surgical complications are necessary. Standardization is possible by combined application of two tools. We believe that this evaluation concept of the surgery morbidity must be used systematically in order to achieve a new standard refined, concise and comparative for reports of adverse perioperative events.
authors.affiliation: Departamento de Urología, Clínica INDISA, Santiago, Chile; Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile. Electronic address: octavio.castillo@indisa.cl.
authors.forename: O A
authors.initials: OA
authors.lastname: Castillo
authors.affiliation: Departamento de Urología, Clínica INDISA, Santiago, Chile.
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez-Carlin
authors.affiliation: Departamento de Urología, Clínica INDISA, Santiago, Chile.
authors.forename: J
authors.initials: J
authors.lastname: López-Vallejo
authors.affiliation: Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile.
authors.forename: V
authors.initials: V
authors.lastname: Borgna
mesh_terms: D000315:Adrenalectomy / Q000009:adverse effects* / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D055815:Young Adult
keywords: Adrenalectomy; Adrenalectomía; Complicaciones; Complications; Laparoscopia; Laparoscopic