{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:24:32Z","timestamp":1791872672202,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Robotic adrenalectomy (RA) is increasingly adopted, but its clinical value compared with laparoscopic adrenalectomy (LA) remains unclear. We assessed perioperative outcomes and the learning curve of RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A bicentric retrospective study included 228 patients who underwent adrenalectomy between 2013 and 2023 (97 RA, 131 LA). Primary outcomes were intra\u2010 and postoperative complications (Clavien\u2013Dindo, Comprehensive Complication Index, CCI). Secondary outcomes included operative time and length of stay (LOS). Subgroup analysis evaluated tumors \u2265\u00a06\u00a0cm. RA learning curve was assessed with cumulative sum (CUSUM) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients in the RA group had higher ASA scores, more prior abdominal surgery, and larger tumors. Overall complication rates were similar (RA 18.6% vs. LA 17.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.846). RA was independently associated with shorter LOS (OR 0.48; 95% CI 0.26\u20130.84;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.012). In tumors \u2265\u00a06\u00a0cm, RA reduced postoperative complications (5.3% vs. 35.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.037). CUSUM analysis showed earlier improvements in operative time (after 25 cases) and later reductions in morbidity (after \u223c\u00a045 cases).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RA is a safe alternative to LA even in complex patients. It shortens LOS overall and improves outcomes in large adrenal tumors. CUSUM analysis highlights a progressive but safe learning curve, supporting the integration of RA into endocrine surgical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70221","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T04:06:08Z","timestamp":1767758768000},"page":"451-460","source":"Crossref","is-referenced-by-count":2,"title":["Robotic Adrenalectomy Is Associated With Shortened Hospital Stay and in Large Tumors (\u2265\u00a06\u00a0cm) May Reduce Complications"],"prefix":"10.1002","volume":"50","author":[{"given":"Noa","family":"Grunberg","sequence":"first","affiliation":[{"name":"Department of Digestive and Endocrine Surgery University Hospital of Orleans  Orl\u00e9ans France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Michot","sequence":"additional","affiliation":[{"name":"Department of Digestive and Endocrine Surgery University Hospital of Tours  Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dussard","sequence":"additional","affiliation":[{"name":"Department of Digestive and Endocrine Surgery University Hospital of Orleans  Orl\u00e9ans France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Saint\u2010Marc","sequence":"additional","affiliation":[{"name":"Department of Digestive and Endocrine Surgery University Hospital of Orleans  Orl\u00e9ans France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Guillermou","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology University of Nimes  Nimes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephrem","family":"Salam\u00e9","sequence":"additional","affiliation":[{"name":"Department of Digestive and Endocrine Surgery University Hospital of Tours  Tours France"},{"name":"University of Tours  Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Ouaissi","sequence":"additional","affiliation":[{"name":"Department of Digestive and Endocrine Surgery University Hospital of Tours  Tours France"},{"name":"University of Tours  Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9053-6313","authenticated-orcid":false,"given":"Haythem","family":"Najah","sequence":"additional","affiliation":[{"name":"Department of Digestive and Endocrine Surgery University Hospital of Orleans  Orl\u00e9ans France"},{"name":"LI<sup>2<\/sup>RSO University of Orleans Ch\u00e2teau de la Source  Orleans France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2019"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13304\u2010017\u20100440\u20101"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199210013271417"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010016\u20104830\u20100"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2020.0839"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2016.12.118"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010020\u201001860\u20109"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2022.106853"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2018.0308"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.22059"},{"issue":"6","key":"e_1_2_10_12_1","first-page":"130","article-title":"Surgical Diseases of the Adrenal Gland","volume":"15","author":"Bissada N. 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