Influence of obesity and overweight in surgical outcomes of adrenalectomy for primary adrenal disease: A cohort study of 146 cases

Objective: To evaluate the impact of obesity and overweight on surgical outcomes in a large cohort of patients who underwent adrenalectomy due to benign or malignant primary adrenal disease.Methods: A retrospective single-center study of patients without history of active extraadrenal malignancy, with adrenal tumors operated on consecutively in our center between January 2010 and December 2022.Obesity was defined as a body mass index (BMI) >= 30 kg/m(2) and overweight as BMI between 25.0 and 30.0 kg/m(2).Results: Of 146 patients with adrenal tumors who underwent adrenalectomy, 9.6% (n = 14) were obese, 54.8% (n = 80) overweight and 35.6% (n = 52) normal weight. Obese patients had higher diastolic blood pressure (87.6 +/- 12.22 vs. 79.3 +/- 10.23 mmHg, P = 0.010) and a higher prevalence of dyslipidemia (57.1% vs. 25.8%, P = 0.014) and bilateral tumors (14.3% vs. 3.1%, P = 0.044) than non-obese patients. The rates of intraoperative and of postsurgical complications were similar between obese/overweight patients and patients with normal weight. However, a significantly higher rate of postsurgical complications (27.3% vs. 5.7%, P = 0.009) and a longer hospital stay (5.4 +/- 1.39 vs. 3.5 +/- 1.78 days, P = 0.007) were observed in patients with obesity than in non-obese patients. In the multivariant analysis, obesity, age, ASA > 2 and tumor size were inde-pendent risk factors for postoperative complications, with obesity being the most important factor (OR 23.34 [2.23-244.24]).Conclusion: Obesity and overweight are common conditions in patients who undergo adrenalectomy. Adrenalectomy is considered a safe procedure in patients with overweight, but it is associated with a higher risk of postsurgical complications and longer hospital stay in obese patients.(c) 2023 SEEN y SED. Published by Elsevier Espana, S.L.U. All rights reserved.