Three-dimensional (3D) system versus two-dimensional (2D) system for laparoscopic resection of adrenal tumors: a case-co
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ORIGINAL ARTICLE
Three-dimensional (3D) system versus two-dimensional (2D) system for laparoscopic resection of adrenal tumors: a case-control study José Ignacio Rodríguez-Hermosa 1,2,3,4 & Alejandro Ranea 1,2,3 & Olga Delisau 2,3 & Pere Planellas-Giné 2,3,4 & Lídia Cornejo 2,3 & Marcel Pujadas 2,3 & Clara Codony 2,3 & Jordi Gironès 1,2,3,4 & Antoni Codina-Cazador 2,3,4 Received: 15 April 2020 / Accepted: 27 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Laparoscopy is the standard technique for resecting adrenal tumors worldwide. The main drawbacks of conventional 2D laparoscopy are limited depth perception and tactile feedback. Currently available high-quality 3D laparoscopy systems might improve surgical outcomes for adrenalectomy. We compare the safety and efficacy of 3D versus 2D laparoscopy in the treatment of adrenal tumors. Methods This case-control study analyzed prospectively collected data from patients with benign or malignant adrenal tumors treated laparoscopically at a single academic medical center between April 2003 and March 2020. We collected demographic, diagnostic, preoperative, and operative variables, and used multiple linear and logistic regression to analyze differences in various short-term outcomes between the two approaches while adjusting for potential confounders. Results We included 150 patients: 128 with benign tumors and 22 with malignant tumors; 95 treated with 3D laparoscopy (case group); and 55 with 2D laparoscopy (control group). After adjustment for patient, surgical, and tumor characteristics, a 2D vision was associated with a longer operative time (β = 0.26, p = 0.002) and greater blood loss (β = 0.20, p = 0.047). There was no significant difference in rates of conversion to open surgery (odds ratio [OR] = 1.47 (95% CI 0.90–22.31); p = 0.549) or complications (3.6% vs. 2.1%; p = 0.624). Conclusions With experienced surgeons, laparoscopic adrenalectomy was safer and more feasible with the 3D system than with the 2D system, resulting in less operative blood loss and shorter operative time with no differences in rates of conversion to open surgery or postoperative complications. For adrenal tumors, 3D laparoscopy offers advantages over 2D laparoscopy. Keywords 3D laparoscopy . 2D laparoscopy . Laparoscopic adrenalectomy . Adrenal surgery . Minimally invasive surgery . Adrenal tumors
* José Ignacio Rodríguez-Hermosa [email protected]; [email protected]
Jordi Gironès [email protected]
Alejandro Ranea [email protected] Olga Delisau [email protected] Pere Planellas-Giné [email protected]
Antoni Codina-Cazador [email protected] 1
Endocrine Surgery Unit, Dr. Josep Trueta University Hospital, Girona, Spain
2
Department of Surgery, Dr. Josep Trueta University Hospital, Girona, Spain
3
Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta University Hospital, Girona, Spain
4
Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
Lídia Cornejo li
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