{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:39:11Z","timestamp":1793723951375,"version":"4.6.1"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T00:00:00Z","timestamp":1664755200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T00:00:00Z","timestamp":1664755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005743","name":"Universit\u00e0 Cattolica del Sacro Cuore","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005743","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Laparoscopic adrenalectomy (LA) is the gold standard treatment for adrenal lesions. Robot-assisted adrenalectomy (RAA) is a safe approach, associated with higher costs in absence of clear-cut benefits. Several series reported some advantages of RAA over LA in challenging cases, but definitive conclusions are lacking. We evaluated the cost effectiveness and outcomes of robotic (R-LTA) and laparoscopic (L-LTA) approach for lateral transabdominal adrenalectomy in a high-volume center.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Among 356 minimally invasive adrenalectomies (January 2012\u2013August 2021), 286 were performed with a lateral transabdominal approach: 191 L-LTA and 95 R-LTA. The R-LTA and L-LTA patients were matched for lesion side and size, hormone secretion, and BMI with propensity score matching (PSM) analysis. Postoperative complications, operative time (OT), postoperative stay (POS), and costs were compared.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>PSM analysis identified 184 patients, 92 in R-LTA and 92 in L-LTA group. The two groups were well matched. The median lesion size was 4\u00a0cm in both groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.533). Hormonal hypersecretion was detected in 55 and 54 patients of R-LTA and L-LTA group, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20091). Median OT was significantly longer in R-LTA group (90.0 vs 65.0\u00a0min) (<jats:italic>p\u2009<\/jats:italic>&lt;\u20090.001). No conversion was registered. Median POS was similar (4.0 vs 3.0\u00a0days in the R-LTA and L-LTA) (<jats:italic>p<\/jats:italic>\u2009=\u20090.467). No difference in postoperative complications was found (<jats:italic>p<\/jats:italic>\u2009=\u20091). The cost margin analysis showed a positive income for both procedures (3137 vs 3968 \u20ac for R-LTA and L-LTA). In the multiple logistic regression analysis, independent risk factors for postoperative complications were hypercortisolism (OR\u2009=\u20093.926, <jats:italic>p<\/jats:italic>\u2009=\u20090.049) and OT\u2009&gt;\u200975\u00a0min (OR\u2009=\u20098.177, <jats:italic>p<\/jats:italic>\u2009=\u20090.048).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The postoperative outcomes of R-LTA and L-TLA were similar in our experience. Despite the higher cost, RAA appears to be cost effective and economically sustainable in a high-volume center (60 adrenalectomies\/year), especially if performed in challenging cases, including patients with large (&gt;\u20096\u00a0cm) and\/or functioning tumors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00464-022-09663-3","type":"journal-article","created":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T15:02:55Z","timestamp":1664809375000},"page":"8619-8629","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Robot-assisted vs laparoscopic lateral transabdominal adrenalectomy: a propensity score matching analysis"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7303-9657","authenticated-orcid":false,"given":"Carmela","family":"De Crea","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0865-700X","authenticated-orcid":false,"given":"Francesco","family":"Pennestr\u00ec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8316-4726","authenticated-orcid":false,"given":"Nikolaos","family":"Voloudakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9894-4792","authenticated-orcid":false,"given":"Luca","family":"Sessa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla Francesca","family":"Procopio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7000-538X","authenticated-orcid":false,"given":"Pierpaolo","family":"Gallucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0844-3469","authenticated-orcid":false,"given":"Rocco","family":"Bellantone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1259-2491","authenticated-orcid":false,"given":"Marco","family":"Raffaelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,3]]},"reference":[{"key":"9663_CR1","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1056\/NEJM199210013271417","volume":"327","author":"M Gagner","year":"1992","unstructured":"Gagner M, Lacroix A, Bolt\u00e9 E (1992) Laparoscopic adrenalectomy in Cushing\u2019s syndrome and pheochromocytoma. 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