Literature DB >> 23132964

Laparoscopic adrenalectomy - a review of initial 24 consecutive patients.

R Venkatasubramanian1, Atul Wadhwa, Anil Sharma, Rajesh Khullar, Vandana Soni, Manish Baijal, P K Chowbey.   

Abstract

AIM: To analyze patient demographics, pathology, surgical procedure and outcome in initial 24 consecutive patients who underwent laparoscopic adrenalectomy in our department.
METHODS: Twenty four patients underwent laparoscopic adrenalectomy between September 2000 and August 2005. There were 12 males and 12 females with a mean age of 44.6 years (range 25-68 years). The indications for adrenalectomy were pheochromocytoma (13 patients), Cushing's syndrome (5 patients), myelolipoma (2 patients), adrenal cyst (2 patients), aldosteronoma (1 patient) and adrenal incidentaloma (1 patient). Nineteen of our patients with functioning adrenal tumours were prepared preoperatively for periods ranging up to 2 weeks by the endocrinologist. All laparoscopic adrenalectomies were performed via lateral transperitoneal approach using standard four-port technique. Patients with pheochromocytoma and Cushing's syndrome were monitored in the surgical intensive care unit during immediate postoperative period. The clinical and intraoperative characteristics, complications and outcomes of all patients were analyzed.
RESULTS: The mean operative time for laparoscopic adrenalectomy was 136 minutes. Intraoperative hypertension occurred in 8 patients. Intraoperative hypotension occurred in 2 patients. One patient required conversion due to dense adhesions and hemorrhage. Postoperative complications were seen in six patients - immediate postoperative hypotension (2 patients), features of steroid withdrawal (2 patients) and postoperative pyrexia (2 patients). Five patients with pheochromocytoma required antihypertensive drugs in the postoperative period. There was no mortality in our series.
CONCLUSIONS: Laparoscopic adrenalectomy is a safe operation that incorporates all the benefits of minimal access surgery and is associated with a satisfactory postoperative outcome. A careful preoperative preparation in functioning adrenal tumours aids in the faster recovery of these patients.

Entities:  

Keywords:  Adrenalectomy; Laparoscopy; Pheochromocytoma

Year:  2008        PMID: 23132964      PMCID: PMC3452464          DOI: 10.1007/s12262-007-0003-7

Source DB:  PubMed          Journal:  Indian J Surg        ISSN: 0973-9793            Impact factor:   0.656


  26 in total

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Authors:  M Gagner; A Lacroix; E Bolté
Journal:  N Engl J Med       Date:  1992-10-01       Impact factor: 91.245

2.  Comparison of laparoscopic and open adrenalectomy.

Authors:  J E Korman; T Ho; J R Hiatt; E H Phillips
Journal:  Am Surg       Date:  1997-10       Impact factor: 0.688

3.  Subtotal adrenalectomy by the posterior retroperitoneoscopic approach.

Authors:  M K Walz; K Peitgen; B Saller; R M Giebler; S Lederbogen; K Nimtz; K Mann; F W Eigler
Journal:  World J Surg       Date:  1998-06       Impact factor: 3.352

4.  Laparoscopic adrenalectomy: a new standard of care.

Authors:  H I Vargas; L R Kavoussi; D L Bartlett; J R Wagner; D J Venzon; D L Fraker; H R Alexander; W M Linehan; M M Walther
Journal:  Urology       Date:  1997-05       Impact factor: 2.649

5.  Laparoscopic adrenalectomy compared to open adrenalectomy for benign adrenal neoplasms.

Authors:  L M Brunt; G M Doherty; J A Norton; N J Soper; M A Quasebarth; J F Moley
Journal:  J Am Coll Surg       Date:  1996-07       Impact factor: 6.113

6.  Laparoscopic versus open posterior adrenalectomy: a case-control study of 100 patients.

Authors:  G B Thompson; C S Grant; J A van Heerden; R T Schlinkert; W F Young; D R Farley; D M Ilstrup
Journal:  Surgery       Date:  1997-12       Impact factor: 3.982

7.  Laparoscopic adrenalectomy: lessons learned from 100 consecutive procedures.

Authors:  M Gagner; A Pomp; B T Heniford; D Pharand; A Lacroix
Journal:  Ann Surg       Date:  1997-09       Impact factor: 12.969

8.  Is laparoscopic adrenalectomy indicated for pheochromocytomas?

Authors:  M Gagner; G Breton; D Pharand; A Pomp
Journal:  Surgery       Date:  1996-12       Impact factor: 3.982

9.  Laparoscopic versus open adrenalectomy for surgical adrenal disease.

Authors:  Niels-Erik B Jacobsen; Jeffrey B Campbell; Michael G Hobart
Journal:  Can J Urol       Date:  2003-10       Impact factor: 1.344

10.  A comparison of laparoscopic and open adrenalectomies.

Authors:  R A Prinz
Journal:  Arch Surg       Date:  1995-05
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