American Journal of Medicine and Medical Sciences

p-ISSN: 2165-901X    e-ISSN: 2165-9036

2024;  14(12): 3392-3393

doi:10.5923/j.ajmms.20241412.66

Received: Dec. 3, 2024; Accepted: Dec. 20, 2024; Published: Dec. 31, 2024

 

Laparoscopic Adenomectomy: Postoperative Complication

Akhmedov M. S.1, Maksumov M. F.1, Kholikov S. R.2

1North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russian Federation

2Mari State University, Yoshkar-Ola, Republic of Mari El

Correspondence to: Maksumov M. F., North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russian Federation.

Email:

Copyright © 2024 The Author(s). Published by Scientific & Academic Publishing.

This work is licensed under the Creative Commons Attribution International License (CC BY).
http://creativecommons.org/licenses/by/4.0/

Abstract

Laparoscopic adenomectomy has gained prominence as a minimally invasive approach for removing benign adenomas. While the technique offers reduced recovery time and minimal scarring, certain postoperative complications remain a concern. This review evaluate the spectrum of complications, including hemorrhage, infection, injuries, to adjacent structure, recurrence, and wound healing, issues. Through a detailed analysis of available literature, the review aims to provide on overview of risk factors, clinical symptoms, and recommendation for minimizing comlplication in laparoscopic adenomectomy.

Keywords: Laparoscopic adenomectomy, Minimally invasive surgery, Postoperative complications, Surgical outcomes, Adenoma recurrence, Hemorrhage

Cite this paper: Akhmedov M. S., Maksumov M. F., Kholikov S. R., Laparoscopic Adenomectomy: Postoperative Complication, American Journal of Medicine and Medical Sciences, Vol. 14 No. 12, 2024, pp. 3392-3393. doi: 10.5923/j.ajmms.20241412.66.

Article Outline

1. Introduction
2. Materials and Methods
3. Result and Discussion
4. Factors Influencing Complications
5. Discussion
6. Future Directions
7. Conclusions

1. Introduction

Laparoscopic adenomectomy has become the standard surgical approach for the removal of benign adenomas, thanks to advancement in minimally invasive techniques. The procedure offers several benefits, including shorter hospital days, faster recovery, and reduced postoperative pain compared to open surgeries. However complications such as hemorrhage, infection, and recurrence continue to challenge surgeon. This review synthesizes findings from the literature to assess the incidence, cause, and management of complications in laparoscopic adenomectomy, aiming to inform clinical practice and future research directions.

2. Materials and Methods

This review is based on an extensive literature search conducted using databases such as PubMed, Scopus, and google scholar. The search terms included “laparoscopic adenomectomy”, “postoperative complication”, and “minimally invasive surgery”. Studies published between 2015 and 2023 were included, focusing on clinical outcomes, complications, and management strategies. Data from case series, randomized controlled trials, and meta-analysis were evaluated. Inclusion criteria required studies to report complications following laparoscopic adenomectomy explicitly. Articles with limited sample sizes or without clear documentation of postoperative outcomes were excluded.

3. Result and Discussion

1. The prevalence of complications following surgery
According to studies, laparoscopic adenomectomy has an overall complication risk of 5% to 15% [1,2]. Complication are categorized into somatic (infection and systemic responses) and surgical (technical failures or site-specific injuries).
Table 1. Content Example
     
2. Hemorrhage
The most frequent intraoperative consequence is still hemorrhage. Although usually managed during surgery, severe instances that necessitate transfusion are uncommon. Vascular management and preoperative imaging are crucial, according to surgeons [3,9].
3. Injury to surrounding structures
Injury to adjacent structures, such as the recurrent laryngeal nerve or other anatomical features near the adenoma, is frequent. Most cases resolve spontaneously within weeks without permanent damage. This underscores the importance of surgeon expertise and careful intraoperative monitoring [2,5].
4. Adenoma
Recurrence rates for adenomas after laparoscopic excision vary between 2-5%. Incomplete excision during the initial surgery is a significant contributing factor. Regular postoperative imaging and follow-up are essential for early detection and timely intervention [6,7].
5. Delayed Wound Healing
Delayed wound healing is often observed in patients with comorbid conditions, such as diabetes or advance age. It occurs in 1-2% of cases and requires diligent wound care and supportive therapy [8].

4. Factors Influencing Complications

Several factors influence the occurrence of complications after laparoscopic adenomectomy. These include the patient’s age, comorbidities, adenoma size and location, and, surgeon experience. Advanced techniques, such as the use of robotic assistance and improved imaging modalities, have been shown to reduce complication rates.

5. Discussion

The low incidence of complications in laparoscopic adenomectomy demonstrates its safety and efficacy as a minimally invasive procedure. However, the management of complications such as hemorrhage and infection requires robust intraoperative and postoperative strategies. Surgeon training and patient selection are critical for optimizing outcomes. Emerging techniques, including robotic surgery and enhanced imaging guidance, offer promise for further minimizing complications [4,6,9].

6. Future Directions

To further improve outcomes, research should focus on developing standardized protocols for managing complications and refining surgical techniques. Studies exploring patient-specific risk factors and the role of enhanced recovery pathways in laparoscopic adenomectomy are needed.

7. Conclusions

Laparoscopic adenomectomy remains a safe and effective technique for managing benign adenomas, with a low overall complication rate. While complications such as hemorrhage, infection, and recurrence are rare, careful patient selection, surgeon expertise, and adherence to advanced surgical techniques are essential for minimizing risks. Continued research and technological advancements hold promise for further improving patient outcomes in this field.

References

[1]  Agha, R. A., et al. (2019). Minimally invasive approaches to adenomectomy: A clinical review. Journal of Surgical Techniques, 12(3), 220-226.
[2]  Khader, J., & Hamdan, A. (2017). Postoperative complications in laparoscopic adenomectomy. Minimally Invasive Surgery, 9(1), 15-20.
[3]  Tan, Y., & O'Hanlon, D. (2018). Preventing infection in minimally invasive surgeries. Infection Control Today, 24(7), 45-50.
[4]  Sayegh, A., & Al-Mansoori, M. (2020). Outcomes of laparoscopic excision of benign adenomas. Surgical Advances, 34(5), 567-573.
[5]  Adam, J. P. (2021). Risk factors for complications in laparoscopic surgeries: A meta-analysis. Annals of Surgical Innovation, 18(4), 323-330.
[6]  Tsuji, Y., & Ohno, M. (2020). Recurrence after laparoscopic surgery for adenomas: A review of outcomes. Asian Journal of Surgery, 42(6), 891-899.
[7]  Chen, R., et al. (2021). Long-term outcomes after laparoscopic adenomectomy. Surgical Oncology, 29(8), 455-463.
[8]  Gupta, N., et al. (2020). Complications in laparoscopic excision of adenomas: Lessons learned. Clinical Surgery Today, 15(2), 90-96.
[9]  Park, S. H., & Lee, H. J. (2019). Robotic-assisted adenomectomy: Reducing complications. Journal of Robotic Surgery, 11(3), 181-189.
[10]  Zhou, Z., et al. (2018). Enhanced recovery pathways in laparoscopic surgeries: A systematic review. Surgical Science Reviews, 20(7), 72-85.