Laparoscopic Adrenalectomy for Treatment of Unilateral Adrenocortical Carcinomas: Technique, Complications, and Results in Seven Dogs

Abstract

Objective-To investigate the feasibility of, and outcome after, laparoscopic adrenalectomy in dogs with unilateral adrenocortical carcinoma. Study Design-Case series. Animals-Dogs (n ¼ 7) with Cushing's syndrome caused by unilateral adrenocortical carcinoma. Methods-Laparoscopic adrenalectomy with the dog in lateral recumbency on the unaffected side. Three 5-mm portals (1 laparoscopic portal, 2 instrument portals) were placed in the paralumbar fossa. A fourth instrumental portal (5-12 mm) was placed above the kidney. After dissection and hemostatic control of the phrenicoabdominal vein, the adrenal gland was carefully dissected or when there was capsule fragility, necrotic content was partially aspirated. The remaining glandular tissue was removed through the 12-mm trocar site. Results-Dogs with unilateral adrenocortical carcinoma (3 right-sided, 4 left-sided) without invasion of the caudal vena cava were successfully operated by laparoscopic approach. There were no significant intraoperative complications; 2 dogs died within 48 hours of surgery because of respiratory complications. Five dogs were discharged 72 hours after surgery, and signs of hyperadrenocorticism disappeared thereafter (survival time ranged from 7 to 25 months). Conclusions-Laparoscopic adrenalectomy is feasible in dogs with either right-or left-sided adrenocortical carcinoma not involving the caudal vena cava. Clinical Relevance-When performed by experienced surgeons, laparoscopic adrenalectomy offers a minimally invasive alternative to open laparotomy or retroperitoneal surgery for the treatment of unilateral adrenocortical carcinoma in dogs. r

Adrenalectomy in dogs: retrospective study of 13 cases performed in Universidade Anhembi Morumbi Veterinary Hospital (2012-2015)

“…Biochemical analysis shows an increase in the levels of PA, ALT, triglycerides and cholesterol. Such changes are also reported by Peláez, Bouvy and Dupré (2008), Lang et al (2011) and Andrade et al (2014).…”

“…In imaging, as far as the side of the occurrence of the masses, Peláez et al (2008) Regarding the intraoperative complications, the most frequently observed is hypotension (LANG et al, 2011;MASSARI et al, 2011;BARRERA et al, 2013;ANDRADE et al, 2014). Three cases of hypotension were observed in this study, one of them along with bradycardia and compensatory ventricular escape.…”

“…The ascertained breeds, there was a heterogeneous representation in the group, noting that Labradors were reported by Schwartz et al (2008), Lang et al (2011), Massari et al (2011, Naan et al (2013) and Andrade et al (2014), followed by Shih-Tzus - Schwartz et al (2008), Lang et al (2011) and Massari et al (2011). Throughout the literature, the condition has been reported to also occur in mixed breed's dogs (PELÁEZ et al, 2008;LANG et al, 2011;MASSARI et al, 2011;BARRERA et al, 2013;NAAN et al, 2013).…”

“…Currently, adrenalectomy is the treatment of choice for unilateral adrenal tumors (PELÁEZ et al, 2008;NELSON, 2010;LANG et al, 2011). However, adrenalectomy is associated with a high rate of perioperative mortality in dogs (SCHWARTZ et al, 2008).…”

Long‐Term Survival of Dogs with Adrenal‐Dependent Hyperadrenocorticism: A Comparison between Mitotane and Twice Daily Trilostane Treatment

“…In addition, adrenalectomy has reported frequencies of intraoperative and postoperative complications of 15–50% of affected dogs, respectively. Perioperative mortality rate of adrenalectomy is high (5–29%)3, 4, 5, 6 and this could lead to unwillingness of the owner to accept the risk of this procedure. When surgery is not indicated or the owner declines surgery, medical management with the adrenocorticolytic drug mitotane has been recommended as an alternative treatment.…”