Skip to main content
SpringerLink
Log in

Outcome of Adrenal Surgery

  • Chapter
  • First Online:
Surgery of the Adrenal Gland

  • 1161 Accesses

Abstract

The laparoscopic adrenalectomy is actually considered the gold standard treatment for adrenal surgical pathology. Concerning the single histotypes, the only relative contraindication of laparoscopic adrenalectomy is the primary adrenocortical carcinoma for the high risk of spillage of malignant cells. The main tips and tricks for laparoscopic adrenalectomy are a correct lateral position of the patients, a correct trocar position, the use of new technologies, a very gently handling of the glands, knowledge of the anatomic landmarks, use of drainage and the repositioning of the splenopancreatic block at the left side. The main complications of open and laparoscopic adrenalectomy are bleeding, glucocorticoid insufficiency, incisional hernia, hypertension, hypotension, ileus, mineralcorticoid insufficiency, Nelson's syndrome, and other minor complications. The main risk factors appear to be surgical inexperience, the age and BMI of the patient, the dimension of the mass, and pheochromocytoma. The limited experience of surgical trainees in adrenalectomy are of critical importance too.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lee J, El-Tamer M, Schifftner T, Turrentine FE, Henderson WG, Khuri S, Hanks JB, Inabnet WB 3rd (2008) Open and laparoscopic adrenalectomy: analysis of the National Surgical Quality Improvement Program. J Am Coll Surg 206(5):953–959

    Article  PubMed  Google Scholar 

  2. Barreca M, Presenti L, Renzi C, Cavallaro G, Borrelli A, Stipa F, Valeri A (2003) Expectations and outcomes when moving from open to laparoscopic adrenalectomy: multivariate analysis. World J Surg 27(2):223–228

    PubMed  Google Scholar 

  3. Gill IS, Hobart MG, Schweizer D, Bravo EL (2000) Outpatient adrenalectomy. J Urol 163(3):717–720

    Article  CAS  PubMed  Google Scholar 

  4. Mohammad WM, Frost I, Moonje V (2009) Outpatient laparoscopic adrenalectomy: a Canadian experience. Surg Laparosc Endosc Percutan Tech 19(4):336–337

    Article  PubMed  Google Scholar 

  5. Pang TC, Bambach C, Monaghan JC, Sidhu SB, Bune A, Delbridge LW, Sywak MS (2007) Outcomes of laparoscopic adrenalectomy for hyperaldosteronism. ANZ J Surg 77(9):768–773

    Article  PubMed  Google Scholar 

  6. Rossi H, Kim A, Prinz RA (2002) Primary hyperaldosteronism in the era of laparoscopic adrenalectomy. Am Surg 68(3):253–256

    PubMed  Google Scholar 

  7. Jeschke K, Janetschek G, Peschel R, Schellander L, Bartsch G, Henning K. (2003) Laparoscopic partial adrenalectomy in patients with aldosterone-producing adenomas: indications, technique, and results. Urology 61(1):69–72

    Google Scholar 

  8. Mishra AK, Agarwal A, Gupta S, Agarwal G, Verma AK, Mishra SK. (2007) Outcome of adrenalectomy for Cushing’s syndrome: experience from a tertiary care center. World J Surg 31(7):1425–1432

    Google Scholar 

  9. Gonçalves FT, Feibelmann TC, Mendes CM, Fernandes ML, Miranda GH, Gouvêa AP, Jorge PT (2006) Primary pigmented nodular adrenocortical disease associated with Carney complex: case report and literature review. Sao Paulo Med J 124(6):336–339

    Article  PubMed  Google Scholar 

  10. Porpiglia F, Fiori C, Bovio S, Destefanis P, Alì A, Terrone C, Fontana D, Scarpa RM, Tempia A, Terzolo M. (2004) Bilateral adrenalectomy for Cushing’s syndrome: a comparison between laparoscopy and open surgery. J Endocrinol Invest 27(7):654–658

    Google Scholar 

  11. Thompson SK, Hayman AV, Ludlam WH, Deveney CW, Loriaux DL, Sheppard BC (2007) Improved quality of life after bilateral laparoscopic adrenalectomy for Cushing’s disease: a 10-year experience. Ann Surg 245(5):790–794

    Article  PubMed  Google Scholar 

  12. Toniato A, Merante-Boschin I, Opocher G, Pelizzo MR, Schiavi F, Ballotta E (2009) Surgical versus conservative management for subclinical Cushing syndrome in adrenal incidentalomas: a prospective randomized study. Ann Surg 249(3):388–391

    Article  PubMed  Google Scholar 

  13. Gumbs AA, Gagner M (2006) Laparoscopic adrenalectomy. Best Pract Res Clin Endocrinol Metab 20(3):483–499

    Article  PubMed  Google Scholar 

  14. Ramacciato G, Mercantini P, La Torre M, Di Benedetto F, Ercolani G, Ravaioli M, Piccoli M, Melotti G (2008) Is laparoscopic adrenalectomy safe and effective for adrenal masses larger than 7 cm? Surg Endosc 22(2):516–521

    Google Scholar 

  15. Grumbach MM, Biller BM, Braunstein GD, Campbell KK, Carney JA, Godley PA, Harris EL, Lee JK, Oertel YC, Posner MC, Schlechte JA, Wieand HS (2003) Management of the clinically inapparent adrenal mass (incidentaloma). Ann Intern Med 138(5):424–429

    PubMed  Google Scholar 

  16. Henneman D, Chang Y, Hodin RA, Berger DL (2009) Effect of laparoscopy on the indications for adrenalectomy. Arch Surg 144(3):255–259

    Article  PubMed  Google Scholar 

  17. Miller BS, Ammori JB, Gauger PG, Broome JT, Hammer GD, Doherty GM (2010) Laparoscopic resection is inappropriate in patients with known or suspected adrenocortical carcinoma. World J Surg 34(6):1380–1385

    Article  CAS  PubMed  Google Scholar 

  18. Valeri A, Bergamini C, Tozzi F, Martellucci J, Di Costanzo F, Antonuzzo L (2011) A multi-center study on the surgical management of metastatic disease to adrenal glands. J Surg Oncol 103(5):400–405

    Article  PubMed  Google Scholar 

  19. Hawn MT, Cook D, Deveney C, Sheppard BC (2002) Quality of life after laparoscopic bilateral adrenalectomy for Cushing’s disease. Surgery 132(6):1064–1068

    Article  PubMed  Google Scholar 

  20. Grabner P, Hauer-Jensen M, Jervell J, Flatmark A (1991) Long-term results of treatment of Cushing’s disease by adrenalectomy. Eur J Surg 157(8):461–464

    CAS  PubMed  Google Scholar 

  21. Simon D, Goretzki PE, Lollert A, Röher HD (1993) Persistent hypertension after successful adrenal operation. Surgery. 114(6):1189–1195

    CAS  PubMed  Google Scholar 

  22. Turrentine FE, Henderson WG, Khuri SF, Schifftner TL, Inabnet WB 3rd, El-Tamer M, Northup CJ, Simpson VB, Neumayer L, Hanks JB (2007) Adrenalectomy in veterans affairs and selected university medical centers: results of the patient safety in surgery study. J Am Coll Surg 204(6):1273–1283

    Article  PubMed  Google Scholar 

  23. Gupta PK, Natarajan B, Pallati PK, Gupta H, Sainath J, Fitzgibbons RJ Jr (2011) Outcomes after laparoscopic adrenalectomy. Surg Endosc 25:784–794

    Article  PubMed  Google Scholar 

  24. Tessier DJ, Iglesias R, Chapman WC, Kercher K, Matthews BD, Gorden DL, Brunt LM (2009) Previously unreported high-grade complications of adrenalectomy. Surg Endosc 23(1):97–102

    Article  PubMed  Google Scholar 

  25. Assalia A, Gagner M (2004) Laparoscopic adrenalectomy. Br J Surg 91(10):1259–1274

    Article  CAS  PubMed  Google Scholar 

  26. Murphy MM, Witkowski ER, Ng SC, McDade TP, Hill JS, Larkin AC, Whalen GF, Litwin DE, Tseng JF (2010) Trends in adrenalectomy: a recent national review. Surg Endosc 24(10):2518–2526

    Article  PubMed  Google Scholar 

  27. Shen WT, Sturgeon C, Clark OH, Duh QY, Kebebew E (2004) Should pheochromocytoma size influence surgical approach? A comparison of 90 malignant and 60 benign pheochromocytomas. Surgery 136(6):1129–1137

    Article  PubMed  Google Scholar 

  28. Saunders BD, Wainess RM, Dimick JB, Doherty GM, Upchurch GR, Gauger PG (2003) Who performs endocrine operations in the United States? Surgery 134(6):924–931

    Article  PubMed  Google Scholar 

  29. Castillo OA, Vitagliano G, Secin FP, Kerkebe M, Arellano L (2008) Laparoscopic adrenalectomy for adrenal masses: does size matter? Urology 71(6):1138–1141

    Article  PubMed  Google Scholar 

  30. Shen ZJ, Chen SW, Wang S, Jin XD, Chen J, Zhu Y, Zhang RM (2007) Predictive factors for open conversion of laparoscopic adrenalectomy: a 13-year review of 456 cases. J Endourol 21(11):1333–1337

    Article  CAS  PubMed  Google Scholar 

  31. Tre′sallet C, Salepcioglu H, Godiris-Petit G, Hoang C, Girerd X, Menegaux F (2010) Clinical outcome after laparoscopic adrenalectomy for primary hyperaldosteronism: the role of pathology. Surgery 148(1):129–134

    Google Scholar 

  32. Kim AW, Quiros RM, Maxhimer JB, El-Ganzouri AR, Prinz RA (2004) Outcome of laparoscopic adrenalectomy for pheochromocytomas vs aldosteronomas. Arch Surg 139(5):526–531

    Article  PubMed  Google Scholar 

  33. Mobius E, Nies C, Rothmund M (1999) Surgical treatment of pheochromocytomas: laparoscopic or conventional? Surg Endosc 13(1):35–39

    Article  CAS  PubMed  Google Scholar 

  34. Mellon MJ, Sundaram CP (2008) Laparoscopic adrenalectomy for pheochromocytoma versus other surgical indications. JSLS 12(4):380–384

    PubMed  Google Scholar 

  35. Ramacciato G, Paolo M, Pietromaria A, Paolo B, Francesco D, Sergio P, Antonio S, Vincenzo T, Micaela P, Gianluigi M (2005) Ten years of laparoscopic adrenalectomy: lesson learned from 104 procedures. Am Surg 71(4):321–325

    PubMed  Google Scholar 

  36. Kercher KW, Novitsky YW, Park A, Matthews BD, Litwin DE, Heniford BT (2005) Laparoscopic curative resection of pheochromocytomas. Ann Surg 241(6):919–928

    Article  PubMed  Google Scholar 

  37. Toniato A, Boschin IM, Opocher G, Guolo A, Pelizzo M, Mantero F (2007) Is the laparoscopic adrenalectomy for pheochromocytoma the best treatment? Surgery 141(6):723–772

    Article  PubMed  Google Scholar 

  38. Zhang X, Lang B, Ouyang JZ, Fu B, Zhang J, Xu K, Wang BJ, Ma X (2007) Retroperitoneoscopic adrenalectomy without previous control of adrenal vein is feasible and safe for pheochromocytoma. Urology 69(5):849–853

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Emergency Room, General and Emergency Medicine and Surgery Dpt, General, Emergency and Mini-invasive Surgery Division, Florence, Italy

    Andrea Valeri & Carlo Bergamini

Authors
  1. Andrea Valeri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carlo Bergamini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carlo Bergamini .

Editor information

Editors and Affiliations

  1. , Chirurgia Generale, d'Urgenza e Mini-inv, Ospedale Careggi, Largo Brambilla 3, Florence, 50134, Italy

    Andrea Valeri

  2. , Chirurgia Generale, d'Urgenza e Mini-inv, Ospedale Careggi, Largo Brambilla 3, Florence, 50134, Italy

    Carlo Bergamini

  3. , Istituto di Semeiotica Chirurgica, Policlinico Gemelli, Largo Agostino Gemelli 8, Rome, 00168, Italy

    Rocco Bellantone

  4. , Istituto di Semeiotica Chirurgica, Policlinico Gemelli, Largo Agostino Gemelli 8, Rome, 00168, Italy

    Celestino Pio Lombardi

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Italia

About this chapter

Cite this chapter

Valeri, A., Bergamini, C. (2013). Outcome of Adrenal Surgery. In: Valeri, A., Bergamini, C., Bellantone, R., Lombardi, C. (eds) Surgery of the Adrenal Gland. Springer, Milano. https://doi.org/10.1007/978-88-470-2586-8_14

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2586-8_14

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2585-1

  • Online ISBN: 978-88-470-2586-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation