Laparoscopic versus open adrenalectomy for surgical adrenal disease.
Bibliographic record
Abstract
OBJECTIVE: To compare the intraoperative and postoperative outcomes of laparoscopic versus open adrenalectomy for surgical adrenal disease. MATERIALS AND METHODS: Prospectively collected data from 22 consecutive laparoscopic adrenalectomies, performed by one surgeon (MGH) over a period of 18 months at the Royal Alexandra Hospital, Edmonton, Alberta, were reviewed. Laparoscopic adrenalectomy was performed by both the transperitoneal and retroperitoneal approaches. In addition, a retrospective chart review was performed for all open adrenalectomies, performed at the same institution, over a 6 year period. Exclusion criteria were locally invasive lesions and masses greater than 8 cm in diameter. Adrenal pheochromocytomas were included in both groups. The two groups were evaluated with respect to intraoperative and postoperative outcomes. RESULTS: Twenty-two laparoscopic and 19 open adrenalectomies were reviewed. Both groups were similar with regard to gender, age, body mass index, and ASA class. Two laparoscopic cases, both with a history of prior ipsilateral adrenal surgery, were converted to the open approach. The laparoscopic group had a longer mean operative time (171 minutes versus 104 minutes), yet had a lower estimated blood loss (146 cc versus 455 cc), blood transfusion rate (0% versus 16%), and intraoperative complication rate (5% versus 16%). Both groups were similar with regard to specimen size and pathology. The laparoscopic group required less post-operative analgesia (44 mg morphine versus 478 mg morphine), resumed a regular diet sooner (1.1 days versus 3.7 days), and had a shorter hospital stay (2.2 days versus 5.4 days). CONCLUSIONS: In our experience, prior ipsilateral adrenal surgery greatly increases the risk of open conversion. This study is consistent with the findings of a number of previously reported studies, supporting the emergence of laparoscopic adrenalectomy as the standard of care for surgical management of benign adrenal disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".