Laparoscopic Adrenalectomy

Brunt, L. Michael

doi:10.1007/0-387-21780-0_26

Cited by 1 publication

(4 citation statements)

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“…Some adrenal lesions such as myelolipomas are apparent by imaging and do not require removal unless they cause local symptoms or enlarge signifi cantly during follow up. Adrenalectomy for adrenal cysts is indicated if patient has hemorrhaged into the cyst or the diagnosis is uncertain [16].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with pheochromocytoma should have an arterial line and central venous pressure line. Hypertensive exacerbations and ventricular arrhythmias are most likely to occur during anesthetic induction, creation of CO 2 pneumoperitoneum and during direct tumour manipulation [16]. These paroxysms are responsible for the morbidity and mortality in patients with pheochromocytoma [16].…”

Section: Discussionmentioning

confidence: 99%

“…Hypertensive exacerbations and ventricular arrhythmias are most likely to occur during anesthetic induction, creation of CO 2 pneumoperitoneum and during direct tumour manipulation [16]. These paroxysms are responsible for the morbidity and mortality in patients with pheochromocytoma [16]. Hence continuous invasive monitoring and pharmacological intervention by a skilled anaesthesia team is necessary to avoid substantial cardiovascular instability [17].…”

Section: Discussionmentioning

confidence: 99%

“…Bleeding has been reported to be the most common reason for conversion to hand assisted or open adrenalectomy. The other reasons for conversion include excessive tumour adhesions to surrounding structures, malignant features and large tumour size [16,22]. The mean conversion rate to open adrenalectomy from a combined series was 3.4% [8].…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic adrenalectomy — a review of initial 24 consecutive patients

et al. 2007

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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. ResultsThe 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 benefi ts 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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%