Adrenalectomy: should urologists not be doing more?
Publication/Presentation Date
2-1-2020
Abstract
PURPOSE: Adrenalectomy is an operation performed by both urologists and general surgeons; however, the majority are performed by general surgeons. We investigated whether there was a difference in outcomes based on surgical specialty performing the procedure. If no differences exist, an argument can be made that urologists should be doing more adrenalectomies.
METHODS: The National Surgical Quality Improvement Project (NSQIP) Participant Use File (PUF) was queried to extract all cases of adrenalectomies performed from 2011 to 2015. Current Procedural Technology (CPT) codes 60540 and 60650 were used. The data were stratified by surgical specialty performing the adrenalectomy (urology or general surgery). Our outcomes of interest included post-surgical complications, reoperations, 30-day readmission, mortality, and hospital length of stay.
RESULTS: A total of 3358 patients who underwent adrenalectomy between 2011 and 2015 were included. General surgeons performed 90% of these (n = 3012) and urologists performed 10% (n = 334). Differences in number of post-surgical complications, length of stay, rate of reoperation, 30-day readmission, and mortality were not statistically significant between general surgeons and urologists (p = 0.76, p = 0.29, p = 0.37, p = 0.98, and p = 0.59, respectively). Small complication rates disallowed multivariable analyses, but unadjusted rates for reoperation, presence of any post-operative complication, readmission within 30 days, and mortality were similar between specialties.
CONCLUSIONS: Surgical specialty did not make a difference in outcomes for patients undergoing adrenalectomy, despite a large disparity in the number of procedures performed by general surgeons versus urologists. Urologists should continue performing adrenalectomies and, given their familiarity with the retroperitoneum, perhaps perform more than is the current trend.
Volume
52
Issue
2
First Page
197
Last Page
204
ISSN
1573-2584
Published In/Presented At
Fuletra, J. G., Schilling, A. L., Canter, D., Hollenbeak, C. S., & Raman, J. D. (2020). Adrenalectomy: should urologists not be doing more?. International urology and nephrology, 52(2), 197–204. https://doi.org/10.1007/s11255-019-02306-y
Disciplines
Medicine and Health Sciences
PubMedID
31595382
Department(s)
Department of Medicine
Document Type
Article