Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

Laparoscopic adrenalectomy: lessons learned from 306 cases

Kuliš, Tomislav and Knežević, Nikola and Pekez, Marijeta and Kaštelan, Darko and Grković, Marija and Kaštelan, Željko (2012) Laparoscopic adrenalectomy: lessons learned from 306 cases. Journal of Laparoendoscopic & Advanced Surgical Techniques, 22 (1). pp. 22-26. ISSN 1092-6429

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    English abstract

    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.

    Item Type: Article
    MeSH: 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
    Divisions: Katedra za internu medicinu
    Katedra za urologiju
    Depositing User: Marijan Šember
    Status: Published
    Kuliš, Tomislav
    Knežević, Nikola
    Pekez, Marijeta
    Kaštelan, Darko
    Grković, Marija
    Kaštelan, Željko
    Date: February 2012
    Date Deposited: 21 Nov 2012 13:02
    Last Modified: 21 Nov 2012 13:02
    Subjects: /
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