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Laparoscopic transperitoneal adrenalectomy

  • C. J. O’BoyleEmail author
  • C. R. Kapadia
  • P. C. Sedman
  • W. A. Brough
  • C. M. S. Royston
Original article

Abstract

Background: From November 1993 to May 2002 a total of 172 laparoscopic adrenalectomies were attempted in 152 patients in centers throughout the United Kingdom. Results: The median age was 52 years (18–77 years). Sixty-three percent were female. Indications for resection were Conn’s syndrome (60), pheochromocytoma (35), Cushing’s disease (24), Cushing’s adenoma (8), cortisol-secreting carcinoma (1), other secreting tumor (2), nonfunctioning adenoma (17), congenital adrenal hyperplasia (4), metastatic disease (7), nonsecreting adrenal carcinoma (2), others (12). Median size of the lesions was 3.0 cm (0.5–20 cm). Median operating time was 65 min (30–170 min). Conversion to an open procedure was necessary in 10 patients (7%). Minor morbidity occurred in nine patients (5%). Major morbidity occurred in two patients (pancreatitis, peritonitis). Median hospital stay was 3 days (1–16 days). At median follow-up of 36 months (1–105 months) five patients (4%) had persistent hypertension. No patient had evidence of recurrent hormonal excess.Conclusions: Laparoscopic removal of the adrenal gland should be considered the surgical procedure of choice in experienced minimally invasive centers.

Keywords

Laparoscopic Adrenalectomy 

References

  1. 1.
    Cougard, P, Peix, JL, Peschaud, F, Goudet, P 2001[Acute pancreatitis after bilateral laparoscopic adrenalectomy in patients with ectopic ACTH syndrome].Ann Chir126336338CrossRefPubMedGoogle Scholar
  2. 2.
    Dudley, NE, Harrison, BJ 1999Comparison of open posterior versus transperitoneal laparoscopic adrenalectomy.Br J Surg86656660CrossRefPubMedGoogle Scholar
  3. 3.
    Gagner, M, Lacroix, A, Bolte, E 1992Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma.N Engl J Med3271033PubMedGoogle Scholar
  4. 4.
    Gagner, M, Breton, G, Pharand, D, Pomp, A 1996Is laparoscopic adrenalectomy indicated for pheochromocytomas?.Surgery12010761079discussion 246–247PubMedGoogle Scholar
  5. 5.
    Gagner, M, Pomp, A, Heniford, BT, Pharand, D, Lacroix, A 1997Laparoscopic adrenalectomy: lessons learned from 100 consecutive procedures.Ann Surg226238246discussion 246–247CrossRefPubMedGoogle Scholar
  6. 6.
    Godellas, CV, Prinz, RA 1998Surgical approach to adrenal neoplasms: laparoscopic versus open adrenalectomy.Surg Oncol Clin N Am7807817PubMedGoogle Scholar
  7. 7.
    Heniford, BT, Arca, MJ, Walsh, RM, Gill, IS 1999Laparoscopic adrenalectomy for cancer.Semin Surg Oncol16293306CrossRefPubMedGoogle Scholar
  8. 8.
    Henry, JF, Defechereux, T, Gramatica, L, Raffaelli, M 1999Should laparoscopic approach be proposed for large and/or potentially malignant adrenal tumors?.Langenbecks Arch Surg384366369CrossRefPubMedGoogle Scholar
  9. 9.
    Henry, JF, Sebag, F, Iacobone, M, Mirallie, E 2002Results of laparoscopic adrenalectomy for large and potentially malignant tumors.World J Surg2610431047CrossRefPubMedGoogle Scholar
  10. 10.
    Imai, T, Kikumori, T, Ohiwa, M, Mase, T, Funahashi, H 1999A case-controlled study of laparoscopic compared with open lateral adrenalectomy.Am J Surg1785053discussion 54CrossRefPubMedGoogle Scholar
  11. 11.
    Kebebew, E, Siperstein, AE, Clark, OH, Duh, QY 2002Results of laparoscopic adrenalectomy for suspected and unsuspected malignant adrenal neoplasms.Arch Surg137948951discussion 952–953CrossRefPubMedGoogle Scholar
  12. 12.
    Ortega, J, Sala, C, Garcia, S, Lledo, S 2002Cost-effectiveness of laparoscopic vs open adrenalectomy: small savings in an expensive process.J Laparoendosc Adv Surg Tech A1215CrossRefPubMedGoogle Scholar
  13. 13.
    Pautler, SE, Choyke, PL, Pavlovich, CP, Daryanani, K, Walther, MM 2002Intraoperative ultrasound aids in dissection during laparoscopic partial adrenalectomy.J Urol16813521355PubMedGoogle Scholar
  14. 14.
    Pillinger, SH, Bambach, CP, Sidhu, S 2002Laparoscopic adrenalectomy: A 6-year experience of 59 cases.Aust NZ J Surg72467470CrossRefGoogle Scholar
  15. 15.
    Porpiglia, F, Garrone, C, Giraudo, G, Destefanis, P, Fontana, D, Morino, M 2001Transperitoneal laparoscopic adrenalectomy: experience in 72 procedures.J Endourol15275279CrossRefPubMedGoogle Scholar
  16. 16.
    Shen, WT, Lim, RC, Siperstein, AE,  et al. 1999Laparoscopic vs open adrenalectomy for the treatment of primary hyperaldosteronism.Arch Surg134628631discussion 631–632CrossRefPubMedGoogle Scholar
  17. 17.
    Terachi, T, Yoshida, O, Matsuda, T,  et al. 2000Complications of laparoscopic and retroperitoneoscopic adrenalectomies in 370 cases in Japan: a multi-institutional study.Biomed Pharmacother54211s214sCrossRefPubMedGoogle Scholar
  18. 18.
    Toniato, A, Piotto, A, Pagetta, C, Bernante, P, Pelizzo, MR 2001Technique and results of laparoscopic adrenalectomy.Langenbecks Arch Surg386200203CrossRefPubMedGoogle Scholar
  19. 19.
    Valeri, A, Borrelli, A, Presenti, L,  et al. 2001Laparoscopic adrenalectomy.Personal experience in 78 patients. G Chir22185189Google Scholar
  20. 20.
    Walther, MM, Herring, J, Choyke, PL, Linehan, WM 2000Laparoscopic partial adrenalectomy in patients with hereditary forms of pheochromocytoma.J Urol1641417PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • C. J. O’Boyle
    • 1
    Email author
  • C. R. Kapadia
    • 2
  • P. C. Sedman
    • 1
  • W. A. Brough
    • 3
  • C. M. S. Royston
    • 1
  1. 1.Ward 60Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZUnited Kingdom
  2. 2.Department of SurgeryAiredale General Hospital, Steeton, Keighley, West YorkshireUnited Kingdom
  3. 3.Macclesfield General Hospital, Victoria Road, Macclesfield, SK103BRUnited Kingdom

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