[Development and evolution of laparoscopic adrenalectomy in an specialized team: from the beginning to the outpatient setting].

Abstract

BACKGROUND:

After the first reports in 1992, laparoscopic adrenalectomy (LA) has evolved technically until becoming the standard approach for the treatment of most of the adrenal gland diseases.

MATERIAL AND METHODS:

Retrospective and descriptive study of 67 patients who underwent 68 LA between January-1998 and December-2008 in the Laparoscopic Surgery Unit of the General and Digestive Surgery Service in a third level hospital (only one case of bilateral LA). The group was divided in 2 periods, P-1 (1998-2003, 22 cases) and P-2 (2004-2008, 45 cases), which have been compared to evaluate the evolution of the LA technique.

RESULTS:

Indications for LA were: 19 incidentalomas, 19 primary hyperaldosteronism, 18 pheocromocitoms, 5 cases of symptomatic and non-functioning adrenal masses, 4 Cushing adenomas and 2 metastases. There was no mortality, only 4 patients had minor complications (6%) and conversion rate was only 3% (2 cases). Mean size of adrenal glands resected was 3.83 cm and the mean operative time was 86 minutes. Mean postoperative hospital stay was 3 days and in P-2 seventeen patients were discharged on an outpatient basis (hospital stay less than 23 hours).

CONCLUSIONS:

In our experience, LA for the treatment of adrenal diseases has shown to be safe, effective and reproducible with low complications and excellent tolerance by patients. When the learning curve is overcome, hospital stay and operative time clearly decrease. As a consequence, LA can be planned in selected cases as outpatient surgery with good results.

• Authors: César P Ramírez-Plaza, Alberto Rodríguez-Cañete, Marta E Domínguez-López, Marta Valle-Carbajo, Carolina Jiménez-Mazure, Naiara Marín-Camero, José L Gallego-Perales, Julio Santoyo-Santoyo
• Journal: Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion (Endocrinol Nutr) Vol. 57 Issue 1 Pg. 22-7 (Jan 2010) ISSN: 1575-0922 [Print] Spain
• Vernacular Title: Desarrollo y evolución de la suprarrenalectomía laparoscópica en una unidad especializada: de los casos iniciales al hospital de día.
• PMID: 20172483 (Publication Type: English Abstract, Journal Article)
• Copyright: Copyright 2010 Sociedad Española de Endocrinología y Nutrición. Published by Elsevier Espana. All rights reserved.

Topics

• Adolescent
• Adrenal Gland Diseases (surgery)
• Adrenalectomy (methods, trends)
• Adult
• Aged
• Female
• Humans
• Laparoscopy
• Male
• Middle Aged
• Retrospective Studies
• Young Adult