A Canadian centre’s experience with prone retroperitoneoscopic adrenalectomy
Bibliographic record
Abstract
<h3>Background:</h3> Minimally invasive adrenalectomy is the standard of care for the surgical management of benign adrenal disease. The transperitoneal laparoscopic approach (TLA) is the most common approach used worldwide; however, many centres have adopted a posterior retroperitoneoscopic approach (PRA), as it is reported to offer several advantages. We describe our experience with PRA. <h3>Methods:</h3> We performed a retrospective review of the charts of patients who underwent minimally invasive adrenalectomy via PRA or TLA performed by a single endocrine surgeon between September 2010 and December 2019 at a tertiary academic centre in British Columbia, Canada. Patient and tumour characteristics, operative times and postoperative outcomes were compared between the 2 groups. <h3>Results:</h3> During the study period, 58 patients underwent adrenalectomy via PRA, and 41 underwent adrenalectomy via TLA. The median American Society of Anesthesiologists score was higher in the TLA group than the PRA group (3.0 v. 2.6, <i>p</i> = 0.02). Adrenal glands were heavier in the TLA group than the PRA group (mean 63.4 g v. 19.2 g, <i>p</i> < 0.001). The mean anesthesia preparation time was shorter with PRA than with TLA (51.5 min v. 63.7 min, <i>p</i> < 0.001), as was mean operative time (77.9 min v. 118.4 min, <i>p</i> < 0.001) and mean hospital length of stay (2 d v. 4 d, <i>p</i> < 0.001). There was no difference in the complication rate between the 2 groups. <h3>Conclusion:</h3> Our study shows that PRA offers shorter operative time and length of stay for appropriately selected patients. Thus, it has become the preferred approach at our centre for minimally invasive adrenalectomy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.004 | 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 teacher head, 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".