Comparison of perioperative morbidity and mortality rates in dogs with noninvasive adrenocortical masses undergoing laparoscopic versus open adrenalectomy

• Published in: Journal of the American Veterinary Medical Association Vol. 245; no. 9; pp. 1028 - 1035
• Main Authors: Mayhew, Philipp D, Culp, William T N, Hunt, Geraldine B, Steffey, Michele A, Mayhew, Kelli N, Fuller, Mark, Della-Maggiore, Ann, Nelson, Richard W
• Format: Journal Article
• Language: English
• Published: United States 01-11-2014
• Subjects: Adrenal Cortex Neoplasms - surgery; Adrenal Cortex Neoplasms - veterinary; Adrenalectomy - adverse effects; Adrenalectomy - mortality; Adrenalectomy - veterinary; Animals; Dog Diseases - mortality; Dog Diseases - pathology; Dogs; Female; Laparoscopy - adverse effects; Laparoscopy - veterinary; Male; Retrospective Studies
• ISSN: 0003-1488; 1943-569X
• DOI: 10.2460/javma.245.9.1028

To describe the clinicopathologic features of a cohort of dogs with adrenocortical masses that underwent laparoscopic adrenalectomy and to compare perioperative morbidity and mortality rates in these dogs with rates for dogs that underwent open adrenalectomy for resection of similarly sized (maximal diameter, ≤ 5 cm) adrenocortical masses.
Retrospective case series.
48 client-owned dogs that underwent laparoscopic (n = 23) or open (25) adrenalectomy for noninvasive tumors (ie, tumors that did not invade the vena cava or other surrounding organs). Procedures-Medical records were reviewed. History, clinical signs, physical examination findings, clinicopathologic findings, imaging results, and surgical variables were recorded. A 3- or 4-port approach was used for laparoscopic adrenalectomy. Surgical time, perioperative complications, postoperative and overall hospitalization times, and perioperative deaths were recorded and compared between groups.
The surgical method for 1 dog was converted from a laparoscopic to an open approach. Perioperative death occurred in no dogs in the laparoscopic group and 2 dogs in the open adrenalectomy group. Surgical time was shorter for laparoscopic (median, 90 minutes; range, 40 to 150 minutes) than for open (median, 120 minutes; range, 75 to 195 minutes) adrenalectomy. Laparoscopic adrenalectomy was associated with shorter hospitalization time and more rapid discharge from the hospital after surgery, compared with the open procedure.
With careful patient selection, laparoscopic adrenalectomy was associated with a low complication rate and low conversion rate for resection of adrenocortical masses as well as shorter surgical and hospitalization times, compared with open adrenalectomy.