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Is larger tumor size a contraindication to retroperitoneal laparoscopic adrenalectomy?

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Abstract

Purpose

To evaluate the surgical feasibility of retroperitoneal laparoscopic adrenalectomy for tumors exceeding 5 cm.

Methods

A retrospective review was carried out on all adrenalectomies performed between 2002 and 2011. All surgical procedures were performed or supervised by one of two experienced laparoscopic surgeons. A total of 133 patients who underwent retroperitoneal laparoscopic adrenalectomy were divided according to tumor size: group I (n = 57) had tumors <5 cm and group II (n = 76) had tumors ≥5 cm. The operative outcomes included surgical time, change in hemoglobin level, estimated blood loss, necessity for blood transfusion, time to ambulation, hospitalization duration, postoperative complications according to the Clavien-Dindo classification, and the rate of conversion to open surgery.

Results

The estimated blood loss (271.75 ± 232.98 mL vs. 367.24 ± 275.11 mL; p = 0.037), time to ambulation (1.60 ± 0.49 days vs. 1.89 ± 0.31 days; p = 0.001), and postoperative hospitalization (7.88 ± 3.08 days vs. 9.264 ± 3.10 days; p = 0.012) were significantly higher in group II. The operation time and hemoglobin level change were not statistically different between groups. Blood transfusions were performed in 3 patients from group I and 6 patients from group II (5.3 vs. 7.9 %; p = 0.449). No patients experienced conversion to open surgery.

Conclusions

Retroperitoneal laparoscopic adrenalectomy can be used in patients with tumors larger than 5 cm.

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Acknowledgments

This study was supported by a grant (CRI 12050-1) Chonnam National University Hospital Biomedical Research Institute.

Conflict of interest

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Authors and Affiliations

  1. Department of Urology, Chonnam National University, 42, Jebongno, Donggu, Gwangju, 501-757, Republic of Korea

    Insang Hwang, Seung-Il Jung, Seong Hyeon Yu, Eu Chang Hwang, Ho Song Yu, Sun-Ouck Kim, Taek Won Kang, Dong Deuk Kwon & Kwangsung Park

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  1. Insang Hwang
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  2. Seung-Il Jung
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Correspondence to Seung-Il Jung.

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Hwang, I., Jung, SI., Yu, S.H. et al. Is larger tumor size a contraindication to retroperitoneal laparoscopic adrenalectomy?. World J Urol 32, 723–728 (2014). https://doi.org/10.1007/s00345-013-1139-7

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  • DOI: https://doi.org/10.1007/s00345-013-1139-7

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