Clinical trial NCT04071561: Prevention of Conversion in Posterior Retroperitoneal Adrenalectomy by Measuring Preoperative Anatomical Conditions
Official title: Prevention of Conversion in Posterior Retroperitoneal Adrenalectomy by Measuring Preoperative Anatomical Conditions on Cross-sectional Imaging (CT or MRI)
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Adrenal Tumor
Adrenal Mass
Pheochromocytoma
Conn Adenoma
Adrenal Metastases
Adrenal Hyperplasia
Keywords: Adrenalectomy
Minimally invasive surgery
Posterior Retroperitoneoscopic adrenalectomy
Retroperitoneal fat mass
Lead sponsor: University of Basel
Sponsor class: OTHER
Collaborators: name: Kantonsspital Aarau
First posted: 2019-08-28
Enrollment: 14
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients who underwent posterior retroperitoneal adrenalectomy at Kantonsspital Aarau.

Brief summary: With our retrospective study the investigators show the limitations of the posterior retroperitoneal adrenalectomy by analyzing anatomical parameters.

The investigators compared the data from one patient who underwent a conversion with 13 patients without a conversion. Furthermore, they explored the influence of these parameters on the operation time and excluded the patient who had a conversion from this analysis.

The investigators hypothesize that by determining anatomical characteristics on cross-sectional imaging (CT or MRI), they can show the limitations of the posterior retroperitoneal adrenalectomy to prevent patients from being converted to lateral transperitoneal adrenalectomy.

Detailed description: Minimally invasive adrenalectomy has become the gold standard for the surgical treatment of small, benign adrenal lesions. In addition to the common laparoscopic lateral transperitoneal adrenalectomy, the posterior retroperitoneal adrenalectomy is becoming increasingly important.

To date, there is no consensus regarding the preferred approach in the resection of benign adrenal tumors. A comprehensive adrenal tumor program should be able to offer both options, however, patient selection criteria for a given approach have not yet been defined. The choice between lateral transperitoneal adrenalectomy and posterior retroperitoneal adrenalectomy is relevant for patients with unilateral tumors \< 6-7 cm and without previous abdominal surgery.

The aim of this study was to determine the limits of posterior retroperitoneal adrenalectomy using anatomical parameters to enable the preferred access to be chosen preoperatively to prevent conversion. In addition, the investigators describe the relationship between these parameters and the operation time to find a measure of the degree of technical difficulty.

Eligibility criteria: Inclusion Criteria:

* Patients whose adrenal gland was removed with retroperitoneal access
* Operation was between 01.07.2016 and 31.12.2018
* Operation was at the Kantonsspital Aarau

Exclusion Criteria:

* Patients with multivisceral resection

Primary outcomes:
measure: Sagittal distance between the dorsal border of the adrenal gland and the 12th rib tip
timeFrame: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
measure: Thickness of retroperitoneal fat
timeFrame: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
measure: Posterior Adiposity Index
timeFrame: The measurement of the parameter from the cross-sectional image was performed in the period from 19.11.2018 - 04.02.2019.
measure: Longitudinal distance between the upper pole of the kidney and the inferior border of the adrenal gland.
timeFrame: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
measure: Longitudinal distance between the superior border of the adrenal gland to the 12th rib tip.
timeFrame: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
measure: Longitudinal distance between the 12th rib and the iliac crest
timeFrame: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
measure: Sagittal thickness of the subcutaneous layer above the 12th rib tip
timeFrame: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
measure: Sagittal thickness of the subcutaneous layer above the iliac crest
timeFrame: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
measure: Thickness of the subcutaneous layer above the 12th rib tip
timeFrame: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
measure: Sagittal thickness of the subcutaneous layer between the center of gravity and the lateral border of the body
timeFrame: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
measure: Tumor size
timeFrame: The measurement was performed in the period from 19.11.2018 - 04.02.2019.
measure: Operative time
timeFrame: The data were collected between 19.11.2018 and 04.02.2019.
Secondary outcomes:
measure: Body-Mass-Index
timeFrame: The data were collected between 19.11.2018 and 04.02.2019.
measure: The side of the adrenal gland that was removed
timeFrame: The data were collected between 19.11.2018 and 04.02.2019.
measure: Previously performed abdominal surgeries taken from the hospital information system
timeFrame: The data were collected between 19.11.2018 and 04.02.2019.
measure: Age
timeFrame: The data were collected between 19.11.2018 and 04.02.2019.
measure: Sex
timeFrame: The data were collected between 19.11.2018 and 04.02.2019.
measure: Histological diagnosis of the sample from the adrenalectomy
timeFrame: The data were collected between 19.11.2018 and 04.02.2019.
measure: Imaging
timeFrame: The data were collected between 19.11.2018 and 04.02.2019.
Other outcomes:
Locations:
city: Basel
country: Switzerland
facility: Simone Eichelberger
Study officials:
affiliation: Kantonsspital Aarau
name: Christian A Nebiker, PD Dr. med.
role: PRINCIPAL_INVESTIGATOR
References: