Laparoscopic Adrenalectomy for Large-Volume (≥5 cm) Adrenal Masses

Hobart, Michael G.; Gill, Inderbir S.; Schweizer, Dana; Sung, Gyung Tak; Bravo, E L

doi:10.1089/end.2000.14.149

Cited by 123 publications

(79 citation statements)

References 21 publications

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“…Large tumor size alone should not be the limiting factor but the presence of local invasion and poor tissue plane on imaging should be taken into consideration for laparoscopic adrenalectomy. 14,15 In the case presented, an open adrenalectomy was considered in view of large lesion and suspicious features on CT imaging.…”

Section: Discussionmentioning

confidence: 99%

Adrenal Schwannoma: A Rare Type of Adrenal Incidentaloma

Said

Muhammad

Othman

et al. 2017

World Journal of Endocrine Surgery

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Benign tumor of the myelin sheath or schwannoma is not uncommon, especially when it involves the peripheral or cranial nerves. But adrenal schwannoma is very rare and commonly presented as an incidentaloma. Adrenal incidentaloma by itself is not uncommon as more imaging is now being performed and its incidence is estimated to be around 4 to 6%. Clinical and imaging studies are not able to differentiate adrenal schwannoma from other causes of incidentaloma, making its diagnosis difficult preoperatively. We report a 64-year-old man who underwent computed tomography (CT) abdomen as part of his health-screening program. An 80 × 70 mm right adrenal tumor was discovered from the CT with features suggestive of malignancy. He has neither apparent abdominal symptoms nor symptoms related to adrenal hypersecretion. Apart from chronic hypertension, he also suffered from morbid obesity with body mass index (BMI) of 38. There was no clinical feature to suggest Cushing disease, pheochromocytoma, or primary hyperaldosteronism. His laboratories evaluation including endocrinology studies consistent with a non-functioning adrenal mass. He underwent an uneventful standard transabdominal right adrenalectomy. Immunohistochemistry report showed the tumor has characteristic of Antoni A type and positive for S-100 immunochemistry stain. The diagnosis of adrenal schwannoma was made. This case report highlights the difficulty in the management of adrenal incidentaloma.

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Section: Discussionmentioning

confidence: 99%

Adrenal Schwannoma: A Rare Type of Adrenal Incidentaloma

Said

Muhammad

Othman

et al. 2017

World Journal of Endocrine Surgery

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“…Despite these limitations, many reports have shown increased blood loss or prolonged operative time that did not translate into increased morbidity. [22][23][24] It is therefore, not unreasonable for us to proceed with the minimally invasive approach for this particular case. The initial dissection around the tumor was performed laparoscopically.…”

Section: Discussionmentioning

confidence: 99%

Salvage Technique for Intraoperative Hemorrhage during Laparoscopic Resection of Large Pheochromocytoma: A Case Report and Literature Review

Singaporewalla¹,

Lee²,

Tan³

2017

World Journal of Endocrine Surgery

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Aim:We described the use of a hand-port assisted laparoscopic adrenalectomy for excising a large 10 cm vascular left adrenal pheochromocytoma. The useful technical tips and important pitfalls to avoid for a successful outcome are discussed in this article. Introduction:A 64-year-old man who was investigated for microalbuminuria was found to have a 10-cm left adrenal mass. Blood investigation and imaging confirmed it to be a pheochromocytoma.

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“…Controversy exists over the maximum acceptable tumour size for laparoscopic adrenalectomy [10]. Barresi and Prinz did not recommend it for lesions more than 6-8cm though masses up to 10-15 cm have been resected laparoscopically [7,11,12]. According to Gagner neoplastic potential rather than size is the crucial issue in deciding the choice of approach [2].…”

Section: Discussionmentioning

confidence: 99%

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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Laparoscopic Adrenalectomy for Large-Volume (≥5 cm) Adrenal Masses

Cited by 123 publications

References 21 publications

Adrenal Schwannoma: A Rare Type of Adrenal Incidentaloma

Adrenal Schwannoma: A Rare Type of Adrenal Incidentaloma

Salvage Technique for Intraoperative Hemorrhage during Laparoscopic Resection of Large Pheochromocytoma: A Case Report and Literature Review

Laparoscopic adrenalectomy — a review of initial 24 consecutive patients

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