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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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
Departments: Katedra za internu medicinu
Katedra za urologiju
Depositing User: Marijan Šember
Status: Published
Kuliš, TomislavUNSPECIFIED
Knežević, NikolaUNSPECIFIED
Pekez, MarijetaUNSPECIFIED
Kaštelan, DarkoUNSPECIFIED
Grković, MarijaUNSPECIFIED
Kaštelan, ŽeljkoUNSPECIFIED
Date: February 2012
Date Deposited: 21 Nov 2012 12:02
Last Modified: 21 Nov 2012 12:02
Subjects: /
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