Treatment Outcomes of Transperitoneal Laparoscopic Adrenalectomy in Patients with Functional Adrenal Gland Tumors

Abstract Background: Laparoscopic adrenalectomy (LA) is the preferred approach to adrenal gland tumors. Objective: To evaluate the perioperative and functional outcomes of transperitoneal LA. Methods: We retrospectively reviewed data of all consecutive patients who underwent transperitoneal LA at our institution between April 2000 and December 2011. Results: Two hundred two patients with mean age of 46 years were included in the study. There were 109 left, 89 right, and 4 bilateral tumors. Preoperative diagnosis included 126 aldosterone-producing adenomas (APA), 33 patients with Cushing syndrome, 19 pheochromocytomas, 20 nonfunctional tumors, and 4 adrenal metastases. Mean tumor size was 3.3 cm (range 0.4-22 cm). Mean operative time was 109 min and estimated blood loss 90 mL for unilateral adrenalectomy; and 195 min and 300 mL for bilateral adrenalectomy. Four patients with pheochromocytoma required transfusion and 2 required conversion to an open approach. Seven intraoperative complications and 18 30-day postoperative complications occurred. These included 5 major complications (Clavien-Dindo grade 3-5). Ninety-seven percent of APA patients had normal serum potassium levels after surgery. Among the patients with functioning endocrine tumors, complete resolution rate from secondary hypertension was significantly higher in the pheochromocytoma group compared with those with APA or Cushing syndrome (82% vs. 48% vs. 68% respectively, p = 0.02). Mean follow up was 35.2 months. Conclusion: LA is the treatment of choice for most adrenal gland tumors with excellent outcomes and low complication rates. There was a high chance for complete resolution of secondary hypertension after surgery for pheochromocytoma.

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PARTIAL LAPAROSCOPIC ADRENALECTOMY - ANATOMICAL BASIS AND OPERATION TECHNIQUE

Wiadomości Lekarskie ◽

10.36740/wlek202009215 ◽

2020 ◽

Vol 73 (9) ◽

pp. 1977-1981

Author(s):

Sergiy P. Styopushkin ◽

Viktor P. Chaikovskyi ◽

Volodymyr A. Chernylovskyi ◽

Ruslan V. Sokolenkо

Keyword(s):

Adrenal Gland ◽

Blood Supply ◽

Laparoscopic Adrenalectomy ◽

Malignant Tumors ◽

Histopathological Examination ◽

Benign Tumors ◽

Operation Technique ◽

Anatomical Basis ◽

Number Of Patients ◽

Adrenal Gland Tumors

The aim: To optimize the indications for partial laparoscopic adrenalectomy (PLA), to give a detailed outline of a PLA technique and to provide technical tips to ensure safe and highly-effectiveness, based on the knowledge of adrenal anatomy and blood supply. Materials and methods: Between January 2010 and September 2018, our department performed 47 adrenal glands surgeries. The operations included 29 total laparoscopic adrenalectomies (TLA), 4 open adrenalectomies (OA) and 14 partial laparoscopic adrenalectomies (PLA). Results: The histopathological examination of all operated patients detected 9 (19.1%) malignant tumors, including 5 metastatic tumors. Benign tumors includes 24 (63%) adenomas, 8 (21%) pheochromocytomas, 4 (10,5%) cysts and 2 (5,5%) ganglioneuromas. Post-PLA histopathological findings revealed 6 adenomas, 2 pheochromocytomas, 4 cysts and 2 ganglioneuromas. Conclusions: Keeping in mind anatomical features of adrenal gland blood supply in highly-selected patients, PLA can be performed in a number of patients. 2 mm of a minimal resection margin is enough to preserve a false tumor recurrence. Anatomically grounded PLA is becoming a new standard of benign adrenal gland tumors treatment, providing an opportunity to save more adrenal gland functional tissue and to prevent hipocorticism development in postoperative period.

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Evaluation of long-term results of radical and organ-sparing operations on adrenal gland tumors

The Scientific Notes of the I P Pavlov St Petersburg State Medical University ◽

10.24884/1607-4181-2014-21-2-36-39 ◽

2014 ◽

Vol 21 (2) ◽

pp. 36-39

Author(s):

V. G. Chausova ◽

P. A. Pankova ◽

E. A. Ramazanova

Keyword(s):

Adrenal Gland ◽

Laparoscopic Adrenalectomy ◽

Long Term Results ◽

Adrenal Tumors ◽

Partial Adrenalectomy ◽

Adrenal Gland Tumors ◽

Organ Sparing

Long-term results have been estimated for laparoscopic adrenalectomy and laparoscopic partial adrenalectomy in the treatment of adrenal tumors. If preoperative data and intra-operating evaluation show no sign of malignancy, it is possible to perform organ-sparing surgery.

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