BACKGROUND: Minimally invasive adrenalectomy has been adopted as the treatment of choice for benign adrenal tumors. This study aimed to investigate the outcome of laparoscopic adrenalectomies performed over a 10-year period at a teaching hospital. METHODS: All laparoscopic adrenalectomies carried out between 1 April 2000 and 31 March 2010 were evaluated with respect to perioperative management, complications, conversion rate, learning curve, tumor size, and surgically relevant characteristics of different adrenal pathologies. RESULTS: Over a period of 10 years, 215 laparoscopic lateral transabdominal adrenalectomies were carried out for Conn's syndrome (n = 90), Cushing's syndrome (n = 72), pheochromocytoma (n = 30), metastatic disease (n = 8), incidentalomas (n = 10), and other rare adrenal pathologies (n = 5). Morbidity, mortality, and conversion rate were 7.0, 0.9, and 4.2 %, respectively. Patients with Cushing's disease and bilateral adrenalectomy showed a higher complication rate. In retrospect, the indication for a laparoscopic approach was at least questionable in five cases. During these 10 years, four surgeons unfamiliar with the technique received intensive training to a defined plan. CONCLUSIONS: Laparoscopic adrenalectomy represents a safe operating technique associated with few complications and a low conversion rate. Patients with severe Cushing's disease are prone to complications and require intensive monitoring postoperatively. Laparoscopic adrenalectomy is associated with a learning curve, and particular emphasis should be given to surgical training.
BACKGROUND: Minimally invasive adrenalectomy has been adopted as the treatment of choice for benign adrenal tumors. This study aimed to investigate the outcome of laparoscopic adrenalectomies performed over a 10-year period at a teaching hospital. METHODS: All laparoscopic adrenalectomies carried out between 1 April 2000 and 31 March 2010 were evaluated with respect to perioperative management, complications, conversion rate, learning curve, tumor size, and surgically relevant characteristics of different adrenal pathologies. RESULTS: Over a period of 10 years, 215 laparoscopic lateral transabdominal adrenalectomies were carried out for Conn's syndrome (n = 90), Cushing's syndrome (n = 72), pheochromocytoma (n = 30), metastatic disease (n = 8), incidentalomas (n = 10), and other rare adrenal pathologies (n = 5). Morbidity, mortality, and conversion rate were 7.0, 0.9, and 4.2 %, respectively. Patients with Cushing's disease and bilateral adrenalectomy showed a higher complication rate. In retrospect, the indication for a laparoscopic approach was at least questionable in five cases. During these 10 years, four surgeons unfamiliar with the technique received intensive training to a defined plan. CONCLUSIONS: Laparoscopic adrenalectomy represents a safe operating technique associated with few complications and a low conversion rate. Patients with severe Cushing's disease are prone to complications and require intensive monitoring postoperatively. Laparoscopic adrenalectomy is associated with a learning curve, and particular emphasis should be given to surgical training.
Authors: David Brix; Bruno Allolio; Wiebke Fenske; Ayman Agha; Henning Dralle; Christian Jurowich; Peter Langer; Thomas Mussack; Christoph Nies; Hubertus Riedmiller; Martin Spahn; Dirk Weismann; Stefanie Hahner; Martin Fassnacht Journal: Eur Urol Date: 2010-06-22 Impact factor: 20.096
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
Authors: Giovanni Ramacciato; Paolo Mercantini; Marco La Torre; Fabrizio Di Benedetto; Giorgio Ercolani; Matteo Ravaioli; Micaela Piccoli; Gianluigi Melotti Journal: Surg Endosc Date: 2007-08-18 Impact factor: 4.584
Authors: Florence E Turrentine; William G Henderson; Shukri F Khuri; Tracy L Schifftner; William B Inabnet; Mahmoud El-Tamer; C Joseph Northup; Virginia B Simpson; Leigh Neumayer; John B Hanks Journal: J Am Coll Surg Date: 2007-06 Impact factor: 6.113
Authors: Jason M Ali; Siong-Seng Liau; Kevin Gunning; Asif Jah; Emmanuel L Huguet; Raaj K Praseedom; Neville V Jamieson Journal: Surgeon Date: 2011-09-15 Impact factor: 2.392
Authors: Lo Hallin Thompson; Erik Nordenström; Martin Almquist; Helene Jacobsson; Anders Bergenfelz Journal: Langenbecks Arch Surg Date: 2016-11-28 Impact factor: 3.445
Authors: Sankalp P Patel; Medjine Jarbath; Lauren Saravis; Peter Senada; David H Lindner; Robert A Grossman; Ricardo A Francosadud Journal: BMC Endocr Disord Date: 2022-08-15 Impact factor: 3.263