Introduction

Minimally invasive adrenalectomy is the standard of care for small adrenal tumours. Both the transperitoneal lateral approach and posterior retroperitoneal approach are widely used and have been proven to be safe and effective. However, the prevalence of chronic postsurgical pain (CPSP) has not been specifically investigated before. The primary goal of this study was to identify the prevalence of CPSP after minimally invasive adrenalectomy.

Methods

A cross-sectional study was performed among all consecutive patients who had undergone minimally invasive adrenalectomy in a single university medical centre. The primary outcome was the prevalence of CPSP. Secondary outcomes were the prevalence of localized hypoesthesia, risk factors for the development of CPSP, and Health-Related Quality of Life. Three questionnaires were used to measure the prevalence and severity of CPSP, hypoesthesia, and Health-Related Quality of Life. Logistic regression analysis was performed to determine risk factors for development of CPSP.

Results

Six hundred two patients underwent minimally invasive adrenalectomy between January 2007 and September 2019, of whom 328 signed informed consent. The prevalence of CPSP was 14.9%. Young age was a significant predictor for developing CPSP. The prevalence of localized hypoesthesia was 15.2%. In patients with CPSP, Health-Related Quality of Life was significantly lower on all domains compared to patients without pain.

Conclusion

The prevalence of CPSP following minimally invasive adrenalectomy is considerable. Furthermore, the presence of CPSP was correlated with a significantly and clinically relevant lower Health-Related Quality of Life. Therefore, these findings should be included in the preoperative counseling of the patient. In the absence of evidence for effective treatment in established chronic pain, prevention should be the key strategy and topic of future research.