The American Journal of Surgery
Volume 194, Issue 2 , Pages 153-158, August 2007

Adrenalectomy in Hong Kong: a critical review of adoption of laparoscopic approach

  • Tim Lok Kwan, M.B.B.S. (HK), F.R.C.S. (Edin.)

      Affiliations

    • Central Surgical Audit Unit, Hospital Authority, 147B Argyle Street, Kowloon, Hong Kong, China
    • Corresponding Author InformationCorresponding author. Department of Surgery, Caritas Medical Centre, Kowloon, Hong Kong, China. Tel.: +852-34087911; fax: +852-21484399.
    • ,
  • Chi Ming Lam, M.S. (HK), F.R.C.S. (Edin.)

      Affiliations

    • Central Surgical Audit Unit, Hospital Authority, 147B Argyle Street, Kowloon, Hong Kong, China
    • ,
  • Albert W.C. Yuen, M.B.B.S. (HK), F.R.A.C.S.

      Affiliations

    • Central Surgical Audit Unit, Hospital Authority, 147B Argyle Street, Kowloon, Hong Kong, China
    • ,
  • Chung Yau Lo, M.S. (HK), F.R.C.S. (Edin.)

      Affiliations

    • Department of Surgery, Queen Mary Hospital, University of Hong Kong Medical Center, Pokfulam, Hong Kong, China

Received 20 June 2006; received in revised form 7 November 2006

Abstract 

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.

Keywords: Adrenalectomy, Laparoscopic approach, Outcome, Population-based study

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PII: S0002-9610(07)00302-9

doi:10.1016/j.amjsurg.2006.11.030

The American Journal of Surgery
Volume 194, Issue 2 , Pages 153-158, August 2007

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