Laparoscopic Adrenalectomy for Potentially Malignant Adrenal Tumors Greater than 5 Centimeters

Cui, Liao; Chueh, Shih-Chieh; Lai, Ming-Kuen; Hsiao, Po-Jen; Chen, Jun

doi:10.1210/jc.2005-2420

Cited by 83 publications

(40 citation statements)

References 19 publications

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“…Likewise, authors from Taiwan reported 39 patients with tumours > 5 cm (mean 6.2 cm), eight of which were malignant (four cortical carcinomas and four metastatic tumours) and were subsequently removed laparascopically. The diaphragm was perforated in one case, pneumonia developed in another one, and the wound was infected in three patients (19).…”

Section: Discussionmentioning

confidence: 97%

Operations on Adrenal Gland Tumours in A Multicentre Study at the Łódź Medical University

Pomorski

Brocki

Kołomecki

et al. 2008

Polish Journal of Surgery

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The aim of the study was to determine the prevalence of adrenal tumours and their types based on the analysis of material from university surgical centres participating in a 5-year study between the years 2001 and 2005. Material and methods. A total of 178 patients, 169 (94.9%) adults and 9 (5.1%) children, with adrenal tumours were treated during the study period. Amongst the operated upon patients, there were 111 (62.4%) females (106 adults and 5 girls) and 67 (37.6%) males (63 adults and 4 boys). The age of patients ranged from 7 months to 82 years (mean 55.4±11.8 years). For children, ages ranged from 7 months to 17 years, while for adults ages ranged from 24 to 82 years. Results. Incidentalomas were detected in 36 (21.3%) of 169 adults, and seven (19.4%) of them were found to be hormonally active in biochemical tests. The patients underwent surgery after the preparation depending on the general state, type of tumour, its functioning, and concomitant diseases. Adrenalectomy was performed using a classical open technique through the lumbal access in 146 (86.4%) adults, and a laparoscopic technique through the retro-or transperitoneal access in 23 (13.6%) adults. In the videolaparoscopic operations, retroperitoneal access was preferred. All children were operated upon by means of the classical technique with trans-abdominal access. Adrenal tumours were most frequent in the 6 th decade of life (33.2% of all tumours). In the adult group, 143 (84.6%) cases of histologically diagnosed benign tumours and 26 (15.4%) cases of malignant neoplasms were found. Sixteen (9.5% of all tumours and 61.5% of malignancies) of them appeared to be secondary metastatic tumours. Moreover, six (66.7%) children had primary malignant adrenal tumours. In three adult patients whose tumours were up to 3 cm in size in the remaining adrenal gland (after previous adrenalectomy on the other side), enucleation was carried out in one patient and partial resection of the only adrenal gland in two patients. The follow-up cortisol levels in the blood sera of these patients appeared to be normal. Conclusions. 1. Adrenal tumours most commonly occur in the 6 th and 7 th decades of patients' lives; an increase in the incidence rate is affected by the percentage of metastases to adrenal glands. 2. Adrenal incidentalomas reveal subclinical hormonal activity in a significant percentage of patients and require adequate preparation prior to surgery. 3. Operations preserving the cortex of the only adrenal gland allow the patients to avoid hormonal substitution therapy. 4. Tumours in children are a separate phenomenon with specific tumour characteristics and origin.

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Section: Discussionmentioning

confidence: 97%

Operations on Adrenal Gland Tumours in A Multicentre Study at the Łódź Medical University

Pomorski

Brocki

Kołomecki

et al. 2008

Polish Journal of Surgery

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“…Liao et al reported that they preferred open surgery for masses greater than 8 cm which would create difficulties in their dissection, and hemostatic control. [16,17] However with increasing expertise in recent years, size of the mass is no longer an indication for open surgery, and various authors have reported their laparoscopic adrenalectomy experience for larger adrenal masses. [18] Nowadays, for laparoscopic adrenalectomy, four different techniques as lateral transperitoneal, anterior transperitoneal, transthoracic, and posterior retroperitoneal techniques have been described.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic transperitoneal adrenalectomy: Our initial results

Özgör

Binbay

Akbulut

et al. 2014

Turkish Journal of Urology

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Objective: To present the first 24 laparoscopic adrenalectomies performed in our clinic because of an adrenal mass. Material and methods:The medical files of 24 patients who underwent laparoscopic adrenalectomy between December 2008 and March 2013 at Haseki Teaching and Research Hospital were analyzed retrospectively. The demographic characteristics of the patients were recorded. Lateral transperitoneal laparoscopic adrenalectomy was performed in all patients. The operation time was defined as the interval between the first incision of the skin and closure of the skin. Intraoperative complications, estimated blood loss and hospital stays of the patients were evaluated. Final pathologies were recorded. Results:The mean age of the patients was 44.2±8.58 years (range: 29-66 years). Nine patients were female and 15 were male. A total of 24 masses were identified in the right (n=11), and left (n=13) adrenal glands masses were identified., Eighteen patients (75%) had no symptoms, and the masses were identified incidentally. The mean operation time was 144±46.1 minutes (range: 90-320 minutes), and the mean blood loss was 74±12.3 mL (range: 50-130 mL). None of the patients required a blood transfusion. In one patient, liver injury was identified intraoperatively due to traction. The mean duration of hospitalization was 2.9±1.1 days (range: 2-5 days). Adrenocortical adenoma and pheochromocytoma were the most common pathologies. Conclusion:Laparoscopic adrenalectomy is a safe and effective method for the treatment of adrenal masses with low complication rates.

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“…From the surgical point of view, laparoscopic adrenalectomy, whether robot-assisted or not, is now a wellestablished procedure with a low complication rate [1,2,20,[23][24][25][26]. In many cases, it would seem sensible to err on the side of caution and excise the tumour even if all malignant criteria are not fulfilled.…”

Section: Discussionmentioning

confidence: 99%

Determinants for malignancy in surgically treated adrenal lesions

Wright

Nordenström

Almquist

2011

Langenbecks Arch Surg

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Laparoscopic Adrenalectomy for Potentially Malignant Adrenal Tumors Greater than 5 Centimeters

Abstract: LA is a reasonable option for selected large adrenal tumors when complete resection is technically feasible and there is no evidence of local invasion. Hand-assisted LA is a good alternative to open conversion if a difficult dissection is encountered intraoperatively.

Cited by 83 publications

References 19 publications

Operations on Adrenal Gland Tumours in A Multicentre Study at the Łódź Medical University

Operations on Adrenal Gland Tumours in A Multicentre Study at the Łódź Medical University

Laparoscopic transperitoneal adrenalectomy: Our initial results

Determinants for malignancy in surgically treated adrenal lesions

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