Journal Article

Early readmission after adrenalectomy for pheochromocytoma. A retrospective study

Yehia, Ahmed M., Abdelaziz, Ahmed Mesbah, Khedr, Ali Hussein, Awad, Esmail Tharwat Kamel, Taher, Ahmed Kamal el, Khyrallh, Ahmed, Habeeb, Tamer A. A. M., Badawy, Mahmoud Hassib Morsi, Gadallah, Mohamed A., Ahmed, Saad Mohamed Ali, Alsayed, Mohammed H., Abdelwanis, Abdelfatah H., Teama, Sobhy Rezk Ahmed, Elias, Abd Al-Kareem, Azawy, Mahmoud El, Elhoofy, Ahmed, Alsaad, Mohamed Ibrahim Abo, Arafa, Ahmed Salah, Khairy, Mostafa M., Ali, Abouelatta KH, Adam, Abdelmonem A. M., Ibrahim, Emad A., Elbelkasi, Hamdi, Shamy, Ibtsam AbdElMaksoud Mohamed El, Zaid, Mahmoud Ali Abou, El-houseiny, Boshra Ali Ali, Nawar, Abdelrahman Mohamed Hasanin, Labib, Mohamed Fathy

2025

Overview

Purpose Adrenalectomy for pheochromocytoma (PHEO) presents a significant challenge due to the high incidence of early hospital readmission (ER). This study evaluated the incidence and risk factors of ER for PHEO within 30 days of adrenalectomy. Methods A retrospective analysis of 346 patients > 18 years with unilateral PHEO who underwent adrenalectomy between September 2012 and September 2024. The patients were categorised into ER ( n  = 49) and no ER ( n  = 297) groups. Logistic regression analyses were performed to predict risk factors for ER. Results The most common causes of ER were postoperative maintained hypotension (42.9%), bleeding (6.1%), ileus (24.5%), wound infection (4.1%), hyperkalemia (8.2%), pneumonia (2%), intra-abdominal abscess (2%), acute MI (4.1%), and colonic injury (6.1%). Most postoperative complications were Clavien-Dindo grade II ( n  = 40, 81.6%). Two perioperative deaths (4%) occurred in the ER group. Logistic regression showed that low body mass index (OR 0.849, 95% CI, 0.748–0.964; p  = 0.012), tumor size < 5 cm (OR 0.096, 95% CI, 0.030–0.310; p  < 0.001), and low ASA (OR 0.435, 95% CI, 0.249–0.761; p  = 0.003) were associated with risk reduction for ER while malignancy (OR 5.302, 95% CI, 1.214–23.164; p  = 0.027), open approach(OR 12.247, 95% CI, 5.227–28.694; p  < 0.001), and intraoperative complications (OR 19.149, 95% CI, 7.091–51.710; p  < 0.001) were associated with risk increase of ER. Conclusion Postoperatively maintained hypotension and ileus were the most common causes of ER. Low body mass index, tumour size < 5 cm, and low ASA were risk reductions for ER, while malignancy, open approach, and intraoperative complications were the independent risk increase factors.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Abdominal Surgery / Adrenal Gland Neoplasms - pathology / Adrenal Gland Neoplasms - surgery / Adrenal glands / Adrenalectomy - adverse effects / Adult / Aged / Blood pressure / Body mass index / Cardiac Surgery / Catecholamines / Female / General Surgery / Hemodynamics / Humans / Hypertension / Hypotension / Incidence / Laparoscopy / Male / Medicine / Medicine & Public Health / Middle Aged / Patient Readmission - statistics & numerical data / Patients / Pheochromocytoma - pathology / Pheochromocytoma - surgery / Postoperative Complications - epidemiology / Postoperative Complications - etiology / Retrospective Studies / Risk Factors / Surgeons / Surgical outcomes / Thoracic Surgery / Traumatic Surgery / Vascular Surgery / Veins & arteries