Skip to main content

Advertisement

Log in

Open adrenalectomy in the era of laparoscopic surgery: a review

  • Review Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

Open adrenalectomy still plays an important role in adrenal surgery. A review of the current literature has been carried out to discuss the main indication to open adrenalectomy with regards to the main adrenal pathologies. The authors underlined the role of open adrenalectomy on the basis of personal experience and a literature review. Indication to open adrenalectomy for adrenal cysts, myelolipomas, pheochromocytomas, metastases, adrenocortical carcinomas and tumour recurrences were analysed and discussed. Open adrenalectomy has still an important role in several adrenal pathologies: it is mandatory in some specific situations, such as big lesions, risk of malignancy, emergency settings and in case of recurrent tumoral disease.

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

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Gagner M, Lacroix A, Bolte E (1033) Laparoscopic adrenalectomy for Cushing’s syndrome and pheochromocytoma. N Engl J Med 1992:327

    Google Scholar 

  2. Lee J, El-Tamer M, Schifftner T et al (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 

  3. Elfenbein DM, Scarborough JE, Speicher PJ et al (2013) Comparison of laparoscopic versus open adrenalectomy: results from American College of Surgeons-National Surgery Quality Improvement Project. J Surg Res 184:216–220

    Article  PubMed  Google Scholar 

  4. Sood J, Jayaraman L, Kumra VP et al (2006) Laparoscopic approach to pheochromocytoma: is a lower intraabdominal pressure helpful? Anesth Analg 102(2):637–641

    Article  PubMed  Google Scholar 

  5. Carter YM, Mazeh H, Sippel RS et al (2012) Safety and feasibility of laparoscopic resection for large (≥6 cm) pheochromocytomas without suspected malignancy. Endocr Pract 18(5):720–726

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sharma R, Ganpule A, Veeramani M et al (2009) Laparoscopic management of adrenal lesions larger than 5 cm in diameter. Urol J 6(4):254–259

    PubMed  Google Scholar 

  7. Abraham GP, Siddaiah AT, Das K et al (2014) Laparoscopic extirpation of giant adrenal ganglioneuroma. J Minim Access Surg 10(1):45–47

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ito T, Kurita Y, Shinbo H et al (2012) A clinical study of laparoscopic adrenalectomy for pheochromocytoma—analysis of clinical parameters influencing operative time and intraoperative systolic blood pressure. Nihon Hinyokika Gakkai Zasshi 103(5):655–659

    PubMed  Google Scholar 

  9. Ramacciato G, Mercantini P, La Torre M et al (2008) Is laparoscopic adrenalectomy safe and effective for adrenal masses larger than 7 cm? Surg Endosc 22(2):516–521

    Article  PubMed  Google Scholar 

  10. Shen ZJ, Chen SW, Wang S et al (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 

  11. Tiberio GA, Solaini L, Arru L et al (2013) Factors influencing outcomes in laparoscopic adrenal surgery. Langenbecks Arch Surg 398(5):735–743

    Article  PubMed  Google Scholar 

  12. Janevska V, Janevski V, Stankov O et al (2015) Non-tumor cystic lesions of the adrenal gland. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 36(3):51–59

    Google Scholar 

  13. Da Silva EC, Viamontez F, Silva VS et al (2012) Haemorrhagic adrenal cyst. Einstein (Sao Paulo) 10(1):96–99

    Article  Google Scholar 

  14. Sebastiano C, Zhao X, Deng FM et al (2013) Cystic lesions of the adrenal gland: our experience over the last 20 years. Hum Pathol 44(9):1797–1803

    Article  PubMed  Google Scholar 

  15. Lyu X, Liu L, Yang L et al (2014) Surgical management of adrenal cysts: a single-institution experience. Int Braz J Urol 40(5):656–665

    Article  PubMed  Google Scholar 

  16. Shenoy VG, Thota A, Shankar R et al (2015) Adrenal myelolipoma: controversies in its management. Indian J Urol 31(2):94–101

    Article  PubMed  PubMed Central  Google Scholar 

  17. Zattoni D, Balzarotti R, Rosso R (2015) The management of bilateral myelolipoma: case report and review of the literature. Int J Surg Case Rep 12:31–36

    Article  PubMed  PubMed Central  Google Scholar 

  18. Zeiger MA, Thompson GB, Duh QV et al (2009) The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas. Endocr Pract 15(1):1–20

    Article  PubMed  Google Scholar 

  19. Daneshmand S, Quek ML (2006) Adrenal myelolipoma: diagnosis and management. Urol J 3(2):71–74

    PubMed  Google Scholar 

  20. Shen X, Qiu Y, Zheng Y et al (2012) Retroperitoneal laparoscopic liposuction for large adrenal myelolipomas: a report of nine cases. J Laparoendosc Adv Surg Tech 22(6):578–580

    Article  Google Scholar 

  21. Vasiliadis K, Papavasiliou C, Fachiridis D et al (2012) Retroperitoneal extra-adrenal ganglioneuroma involving the infrahepatic inferior vena cava, celiac axis and superior mesenteric artery: a case report. Int J Surg Case Rep 11(3):541–543

    Article  Google Scholar 

  22. Acin-Gandara D, Carabias A, Bertomeu A et al (2010) Giant retroperitoneal ganglioneuroma. Rev Esp Enferm Dig 102(3):205–207

    Article  CAS  PubMed  Google Scholar 

  23. Wan Z, Yin T, Chen H et al (2016) Surgical treatment of a retroperitoneal benign tumor surrounding important blood vessels by fractionated resection: a case report and review of the literature. Oncol Lett 5(11):3259–3264

    Google Scholar 

  24. Fernández-Cruz L, Taurá P, Sáenz A et al (1996) Laparoscopic approach to pheochromocytoma: hemodynamic changes and catecholamine secretion. World J Surg 20(7):762–768

    Article  PubMed  Google Scholar 

  25. Tanaka M, Tokuda N, Koga H et al (2000) Laparoscopic adrenalectomy for pheochromocytoma: comparison with open adrenalectomy and comparison of laparoscopic surgery for pheochromocytoma versus other adrenal tumors. J Endourol 14(5):427–431

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  27. Kalady MF, McKinlay R, Olson JA Jr et al (2004) Laparoscopic adrenalectomy for pheochromocytoma. A comparison to aldosteronoma and incidentaloma. Surg Endosc 18(4):621–625

    Article  CAS  PubMed  Google Scholar 

  28. National Comprehensive Cancer Network Inc (2012) NCCN Guidelines, Neuroendocrine Tumors. © JNCCN—Journal of the National Comprehensive Cancer Network 10(6)

  29. Conzo G, Musella M, Corcione F et al (2013) Laparoscopic adrenalectomy, a safe procedure for pheochromocytoma. A retrospective review of clinical series. Int J Surg 11(2):152–156

    Article  PubMed  Google Scholar 

  30. Lenders JWM, Duh QY, Eisenhofer G et al (2014) Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99(6):1915–1942

    Article  CAS  PubMed  Google Scholar 

  31. Kercher KW, Novitsky YW, Park A et al (2005) Laparoscopic curative resection of pheochromocytomas. Ann Surg 241(6):919–926

    Article  PubMed  PubMed Central  Google Scholar 

  32. Bradley CT, Strong VE (2014) Surgical management of adrenal metastases. J Surg Oncol 109(1):31–35

    Article  PubMed  Google Scholar 

  33. Kim SH, Brennan MF, Russo P et al (2004) The role of surgery in the treatment of clinically isolated adrenal metastasis. Cancer 82:389–394

    Article  Google Scholar 

  34. Sarela AI, Murphy I, Coit DG et al (2004) Metastasis to the adrenal gland: the emerging role of laparoscopic surgery. Ann Surg Oncol 10:1191–1196

    Article  Google Scholar 

  35. Gryn A, Peyronnet B, Manunta A et al (2015) Patient selection for laparoscopic excision of adrenal metastases: a multicenter cohort study. Int J Surg 24:75–80

    Article  PubMed  Google Scholar 

  36. Barone M, Di Nuzzo D, Cipollone G, Camplese P, Mucilli F (2015) Oligometastatic non-small cell lung cancer (NSCLC): adrenal metastases. Experience in a single institution. Updates Surg. 67(4):383–387

    Article  PubMed  Google Scholar 

  37. Barzon L, Sonino N, Fallo F et al (2003) Prevalence and natural history of adrenal incidentalomas. Eur J Endocrinol 149:273–285

    Article  CAS  PubMed  Google Scholar 

  38. NIH (2002) State-of-the-science statement on management of the clinically inapparent adrenal mass (“incidentaloma”). NIH Consens State Sci Statements 19:1–25

    Google Scholar 

  39. Schulick RD, Brennan MF (1999) Adrenocortical carcinoma. World J Urol 17:26–34

    Article  CAS  PubMed  Google Scholar 

  40. Sturgeon C, Kebebew E (2004) Laparoscopic adrenalectomy for malignancy. Surg Clin N Am 84:755–774

    Article  PubMed  Google Scholar 

  41. Abiven G, Coste J, Groussin L et al (2006) Clinical and biological features in the prognosis of adrenocortical cancer: poor outcome of cortisol-secreting tumors in a series of 202 consecutive patients. J Clin Endocrinol Metab 91:2650–2655

    Article  CAS  PubMed  Google Scholar 

  42. Fassnacht M, Kenn W, Allolio B et al (2004) Adrenal tumors: how to establish malignancy? J Endocrinol Investig 27:387–399

    Article  CAS  Google Scholar 

  43. Heinz-Peer G, Memarsadeghi M, Niederle B (2007) Imaging of adrenal masses. Curr Opin Urol 17:32–38

    Article  PubMed  Google Scholar 

  44. Han SJ, Kim TS, Jeon SW et al (2007) Analysis of adrenal masses by 18F-FDG positron emission tomography scanning. Int J Clin Pract 61:802–809

    Article  PubMed  Google Scholar 

  45. Bellantone R, Lombardi CP, Raffaelli M (2015) What is the appropriate role of minimally invasive vs. open surgery for small adrenocortical cancers? Curr Opin Oncol 27(1):44–49

    Article  PubMed  Google Scholar 

  46. Donatini G, Caiazzo R, Do Cao C et al (2014) Long-term survival after adrenalectomy for stage I/II adrenocortical carcinoma (ACC): a retrospective comparative cohort study of laparoscopic versus open approach. Ann Surg Oncol 21:284–291

    Article  PubMed  Google Scholar 

  47. Sgourakis G, Lanitis S, Kouloura A et al (2015) Laparoscopic versus open adrenalectomy for stage I/II adrenocortical carcinoma: meta-analysis of outcomes. J Investig Surg 28:145–152

    Article  Google Scholar 

  48. Miller BS, Ammori JB, Gauger PG et al (2010) Laparoscopic resection is inappropriate in patients with known or suspected adrenocortical carcinoma. World J Surg 34:1380–1385

    Article  CAS  PubMed  Google Scholar 

  49. Miller BS, Gauger PG, Hammer GD et al (2012) Resection of adrenocortical carcinoma is less complete and local recurrence occurs sooner and more often after laparoscopic adrenalectomy than after open adrenalectomy. Surgery 152(6):1150–1157

    Article  PubMed  Google Scholar 

  50. Cooper AB, Amir Habra M, Grubbs EG et al (2013) Does laparoscopic adrenalectomy jeopardize oncologic outcomes for patients with adrenocortical carcinoma? Surg Endosc 27:4026–4032

    Article  PubMed  Google Scholar 

  51. Autorino R, Bove P, De Sio M et al (2016) Open versus laparoscopic adrenalectomy for adrenocortical carcinoma: a meta-analysis of surgical and oncological outcomes. Ann Surg Oncol 23:1195–1202

    Article  PubMed  Google Scholar 

  52. Dy BM, Wise KB, Richards ML et al (2013) Operative intervention for recurrent adrenocortical cancer. Surgery 154(6):1292–1299

    Article  PubMed  Google Scholar 

  53. Simon G, Pattou F, Mirallié E et al (2017) Surgery for recurrent adrenocortical carcinoma: a multicenter retrospective study. Surgery 161(1):249–256. doi:10.1016/j.surg.2016.08.058

    Article  PubMed  Google Scholar 

  54. Simon G, Pattou F, Mirallié E et al (1997) Surgery for recurrent adrenocortical carcinoma: a multicenter retrospective study. Surgery 122(6):1212–1218

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francesco Minni.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest. The study is conducted in compliance with the ethical standards.

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Taffurelli, G., Ricci, C., Casadei, R. et al. Open adrenalectomy in the era of laparoscopic surgery: a review. Updates Surg 69, 135–143 (2017). https://doi.org/10.1007/s13304-017-0440-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-017-0440-1

Keywords

Navigation