The change in the principle of performing laparoscopic adrenalectomy from small to large masses.

Abstract

BACKGROUND:

Laparoscopic adrenalectomy has become the gold standard in most patients with adrenal tumors. It is unclear; however, at what size an adrenal neoplasm should be resected by means of an open or a laparoscopic approach. The aim of the present study was to compare the outcomes of laparoscopic adrenalectomy for large tumors with smaller tumors.

METHODS:

A prospective study of patients who underwent adrenalectomy during the period 2006-2009 was undertaken. The patients were divided into 2 groups according to the tumor size. Group 1 (n=29) consisted of patients presenting tumors smaller than 5 cm in diameter; group 2 (n=31) consisted of patients with tumors larger than 5 cm in diameter.

RESULTS:

Two of the 29 tumors in group 1 (6.8%) were malignant at final histology. However, 11 of the 31 tumors in group 2 (35.4%) were malignant. There were no significant differences between operating time and complications of groups 1 and 2. The intra-operative blood loss was significantly lower in group 1 than in group 2.

CONCLUSION:

Laparoscopic adrenalectomy is a reasonable procedure for selected large adrenal tumors when a complete resection is technically feasible and there is no evidence of local invasion.

• Authors: Yeşim Erbil, Umut Barbaros, Gülay Karaman, Alp Bozbora, Selçuk Ozarmağan
• Journal: International journal of surgery (London, England) (Int J Surg) Vol. 7 Issue 3 Pg. 266-71 (Jun 2009) ISSN: 1743-9159 [Electronic] England
• PMID: 19410021 (Publication Type: Comparative Study, Journal Article)

Topics

• Adrenal Gland Neoplasms (pathology, surgery)
• Adrenalectomy (methods)
• Adult
• Analysis of Variance
• Blood Loss, Surgical (statistics & numerical data)
• Chi-Square Distribution
• Female
• Humans
• Laparoscopy (methods)
• Male
• Middle Aged
• Prospective Studies
• Statistics, Nonparametric
• Treatment Outcome