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Laparoscopic and robot-assisted transperitoneal lateral adrenalectomy: a large clinical series from a single center

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Abstract

Since Gagner performed the first laparoscopic adrenalectomy (LTLA) in 1992, laparoscopy has become the gold-standard procedure in the treatment of adrenal surgical diseases. Among all laparoscopic approaches, the transperitoneal lateral adrenalectomy (LTLA) is currently the most widespread procedure. The aim of this article is to analyze our experience in laparoscopy and robot-assisted laparoscopy for the management of surgical adrenal diseases and to value the safety and feasibility of those surgical approaches. From May 2011 until December 2018 were performed 112 adrenalectomies for adrenal tumors by the second division of General Surgery of tertiary care “A. Cardarelli” Hospital of Naples. Out of these, eight operations were carried out with an open surgery approach. Laparoscopic surgery was performed in 104 patients: 64 patients underwent to laparoscopic surgery (LTLA) and 40 patients were treated with a robot-assisted laparoscopy approach. Operative time, intraoperative blood loss, conversion rate, complications, and length of hospital stay were analyzed. Most patients were female and the mean age was 57.2 years in LTLA group, while in the r-LTLA group, the mean age was 55.7 years. Among the adrenal tumors, 55 were left-sided and 49 were right-sided. Median operative time was shorter in r-LTLA (102.2 ± 44.5 min) than in LTLA (128.5 ± 46.5 min). Conversion from LTLA to open surgery occurred in four cases. There were no statistical differences about tumor size and post-operative complications in the analyzed groups. A shorter hospitalization and intermediate care were recorded in the r-LTLA group. LTLA and r-LTLA are safe and effective approaches which ensure successful outcomes for the treatment of adrenal gland tumors.

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Authors and Affiliations

  1. UOC Chirurgia Generale 2, AORN Cardarelli, Naples, Italy

    Antonello Niglio, Luciana Costigliola, Pasquale Zenone & Maurizio De Palma

  2. Faculty of Medicine and Surgery, University of Salerno, Via S. Allende, 84080, Baronissi, Salerno, Italy

    Marica Grasso

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  1. Antonello Niglio
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  2. Marica Grasso
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  3. Luciana Costigliola
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  4. Pasquale Zenone
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  5. Maurizio De Palma
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Correspondence to Marica Grasso.

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All procedures, involving human participants, were in accordance with the ethical standards of the “A. Cardarelli” Hospital and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants involved in the study.

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Niglio, A., Grasso, M., Costigliola, L. et al. Laparoscopic and robot-assisted transperitoneal lateral adrenalectomy: a large clinical series from a single center. Updates Surg 72, 193–198 (2020). https://doi.org/10.1007/s13304-019-00675-8

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  • DOI: https://doi.org/10.1007/s13304-019-00675-8

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