A M Kazaryan1, T Mala, B Edwin. 1. Interventional Center and the Surgical Department, National Hospital, University of Oslo, Norway. aikazar@hotmail.com
Abstract
BACKGROUND: Laparoscopic adrenalectomy is safe and effective for small adrenal tumors, but its role for large adrenal tumors and the influence of tumor size on the outcome of laparoscopic adrenalectomy have been questioned. PATIENTS AND METHODS: Thirty-one patients with unilateral adrenal tumors operated on between January 1997 and April 2000 were selected for this study. The indications for surgery were Conn's adenoma in 16 patients, pheochromocytoma in 7 patients, Cushing's adenoma in 4 patients, and incidental lesions in 4 patients. The patients were divided in two groups: 19 patients with tumors <3.5 cm (Group I) and 12 patients with tumors > or = 3.5 cm (Group II). The outcomes of the two groups were compared. RESULTS: None of the laparoscopic procedures was converted to open surgery. The tumor size correlated with operative time (r = 0.434; P = 0.015) and blood loss (r = 0.513; P = 0.003), with both being significantly greater for larger tumors. No patient required a blood transfusion during or after surgery. One preoperative complication occurred in Group I. There was no peroperative complication in Group II. The median postoperative hospital stay and opioid requirement did not differ significantly between the groups. One patient in Group I developed pneumonia, while no postoperative complications were recorded in Group II. CONCLUSION: Surgery for large adrenal tumors can safely be performed laparoscopically with outcomes comparable to those of surgery for small tumors.
BACKGROUND: Laparoscopic adrenalectomy is safe and effective for small adrenal tumors, but its role for large adrenal tumors and the influence of tumor size on the outcome of laparoscopic adrenalectomy have been questioned. PATIENTS AND METHODS: Thirty-one patients with unilateral adrenal tumors operated on between January 1997 and April 2000 were selected for this study. The indications for surgery were Conn's adenoma in 16 patients, pheochromocytoma in 7 patients, Cushing's adenoma in 4 patients, and incidental lesions in 4 patients. The patients were divided in two groups: 19 patients with tumors <3.5 cm (Group I) and 12 patients with tumors > or = 3.5 cm (Group II). The outcomes of the two groups were compared. RESULTS: None of the laparoscopic procedures was converted to open surgery. The tumor size correlated with operative time (r = 0.434; P = 0.015) and blood loss (r = 0.513; P = 0.003), with both being significantly greater for larger tumors. No patient required a blood transfusion during or after surgery. One preoperative complication occurred in Group I. There was no peroperative complication in Group II. The median postoperative hospital stay and opioid requirement did not differ significantly between the groups. One patient in Group I developed pneumonia, while no postoperative complications were recorded in Group II. CONCLUSION: Surgery for large adrenal tumors can safely be performed laparoscopically with outcomes comparable to those of surgery for small tumors.
Authors: Carlo V Feo; Mattia Portinari; Umberto Maestroni; Paolo Del Rio; Silvia Severi; Lorenzo Viani; Riccardo Pravisani; Giorgio Soliani; Maria Chiara Zatelli; Maria Rosaria Ambrosio; Jenny Tong; Giovanni Terrosu; Vittorio Bresadola Journal: Surg Endosc Date: 2015-11-05 Impact factor: 4.584
Authors: Laura Alberici; Alessandro M Paganini; Francesco Minni; Guido Alberto Massimo Tiberio; Claudio Ricci; Andrea Balla; Zeno Ballarini; Monica Ortenzi; Giovanni Casole; Silvia Quaresima; Guido Di Dalmazi; Pietro Ursi; Marie Sophie Alfano; Saverio Selva; Riccardo Casadei; Carlo Ingaldi; Giovanni Lezoche; Mario Guerrieri Journal: Surg Endosc Date: 2021-08-17 Impact factor: 4.584