Laparoscopic adrenalectomy (LA) has become the “gold standard” for treating most adrenal tumors in the past decade. However, it is still considered a relatively complicated procedure requiring experience from surgeon. The aim of the study was to evaluate the safety of laparoscopic adrenalectomy performed by residents who are undergoing training in general surgery. A prospectively collected database containing all 300 transperitoneal laparoscopic adrenalectomies performed in II Department of General Surgery JU MC, Krakow between January 2013 and March 2018 was retrospectively reviewed. Patients were divided into two groups; patients operated on by residents (group 1, 54 operations) and by attending general surgeons (group 2, 246 operations). We compared the course of the operation and patient hospitalization in these two groups. If the operation was completed by a different person than the one who started the procedure, we refer to this as “operator conversion”. We found no differences in demographic factors or comorbidities between the two groups. The mean operative time was similar in the residents’ and the specialists’ groups (p = 0.5761). Median blood loss did not differ between the groups (p = 0.4325). The overall ratio of intraoperative adverse events was similar in both groups (p = 0.8643). The difference in the ratio of perioperative complications between the groups was not statistically significant (p = 0.6442). The average mean hospital stay after surgery was 2 days for both groups. We identified 25 cases (8.33%) of operator conversion; the difference in operator conversions between two groups was not statistically significant (p = 0.1741). Laparoscopic transperitoneal adrenalectomy performed by a supervised resident is a safe procedure. The course of the operation and patient hospitalization did not differ importantly when comparing procedures performed by residents and attending surgeons. Liberal use of operator conversions from resident to attending surgeon and from a surgeon to a senior surgeon provides reasonable safety and prevents complications. In high-volume centers performing minimally invasive techniques, closed supervision allows residents to safely perform LA.

中文翻译：

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腹腔镜肾上腺切除术-在接受培训的居民手中是否安全？

在过去的十年中，腹腔镜肾上腺切除术（LA）已成为治疗大多数肾上腺肿瘤的“金标准”。然而，它仍然被认为是相对复杂的过程，需要外科医生的经验。这项研究的目的是评估接受普通外科手术培训的居民进行的腹腔镜肾上腺切除术的安全性。回顾性收集了前瞻性收集的数据库，该数据库包含2013年1月至2018年3月在克拉科夫第二普通外科JU MC中心进行的所有300例经腹腔镜腹腔镜肾上腺切除术。患者分为两组。患者由居民进行手术（第1组，共54例），并由普通外科医师进行手术（第2组，共246例）。我们比较了两组的手术过程和患者住院情况。如果操作是由与执行该过程的人不同的人完成的，则我们将其称为“操作员转换”。我们发现两组之间的人口统计学因素或合并症没有差异。居民组和专家组的平均手术时间相似（p = 0.5761）。两组之间的中位数失血没有差异（p = 0.4325）。两组术中不良事件的总比率相似（p = 0.8643）。两组之间围手术期并发症比率的差异无统计学意义（p = 0.6442）。两组术后平均住院时间均为2天。我们确定了25例（8.33％）运营商转换案例；两组之间的运算符转换差异无统计学意义（p = 0.1741）。由有监督的居民进行腹腔镜经腹膜肾上腺切除术是安全的程序。在比较居民和主治医生的手术过程时，手术过程和患者住院治疗没有重要差异。从住院医师到主治医生以及从外科医生到高级外科医生的操作员转换自由使用，可提供合理的安全性并防止并发症。在执行微创技术的高容量中心，封闭式监管使居民能够安全地执行LA。从住院医师到主治医生以及从外科医生到高级外科医生的操作员转换自由使用，可提供合理的安全性并防止并发症。在执行微创技术的高容量中心，封闭式监管使居民能够安全地执行LA。从住院医师到主治医生以及从外科医生到高级外科医生的操作员转换自由使用，可提供合理的安全性并防止并发症。在执行微创技术的高容量中心，封闭式监管使居民能够安全地执行LA。