Laparoscopic adrenalectomy: lessons learned from 306 cases

Professional paper - Review paper

• Author: Tomislav Kuliš
• Author: Nikola Knežević
• Author: Marijeta Pekez
• Author: Darko Kaštelan
• Author: Marija Grković
• Author: Željko Kaštelan
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

INTRODUCTION:

Laparoscopic adrenalectomy has become the standard of care for the surgical treatment of benign adrenal pathology. We present the following case series documenting our experience in refinement of this approach. PAIENTS AND METHODS: Analysis of patient records identified those in whom laparoscopic adrenalectomy was performed from January 1997 through February 2010. Study variables included indications, operative time, blood loss, length of hospital stay, histopathological evaluation, and complications. ----- RESULTS:

Laparoscopic adrenalectomy was performed in 306 patients using the transperitoneal lateral approach. No major operative complications were noted, and postoperative complications included a pulmonary embolism and 2 cases of pneumonia. Conversion to the open approach was necessitated in two cases. The median operative time was 95±29 minutes (range, 45-145 minutes). Estimated blood loss was 60 mL (range, 30-150 mL). The mean size of the removed gland was 5.9±1.6 cm (range, 3-13 cm). The mean size of the tumor was 5±2 cm (range, 0.5-12 cm). The median hospitalization was 4±3.7 days (range, 2-22 days). Adrenal pathology included adenoma (n=164), pheochromocytoma (n=79), hyperplasia (n=35), metastatic carcinoma (n=22), cyst (n=9), myelolipoma (n=9), hemangioma (n=3), ganglioneuroma (n=3), and melanoma (n=2). ----- CONCLUSION:

Laparoscopic adrenalectomy is a safe and feasible approach to adrenal pathology, providing the patients with all the benefits of minimally invasive surgery.

• Keywords (english): Adenoma/surgery; Adolescent; Adrenal Gland Diseases/pathology; Adrenal Gland Diseases/surgery; Adrenal Gland Neoplasms/radiography; Adrenal Gland Neoplasms/surgery; Adrenal Glands/pathology; Adrenalectomy/methods; Adrenalectomy/statistics & numerical data; Adult; Aged; Blood Loss, Surgical/statistics & numerical data; Cushing Syndrome/surgery; Female; Humans; Hyperplasia; Length of Stay; Male; Middle Aged; Pheochromocytoma/surgery; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
• Language: english
• Publication type: Professional paper - Review paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: Journal of Laparoendoscopic & Advanced Surgical Techniques
• Numbering: vol. 22, no. 1, pp. 22-26
• p-ISSN: 1092-6429
• DOI: https://doi.org/10.1089/lap.2011.0376
• URN:NBN: urn:nbn:hr:105:369757
• Publication: 2012-02
• Document URL: https://doi.org/10.1089/lap.2011.0376
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-27 19:31:53