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Open Access 01-04-2019 | Adrenal Cancer | Research

Laparoscopic adrenalectomy: preoperative data, surgical technique and clinical outcomes

Authors: Giuseppe Di Buono, Salvatore Buscemi, Attilio Ignazio Lo Monte, Girolamo Geraci, Vincenzo Sorce, Roberto Citarrella, Eliana Gulotta, Vincenzo Davide Palumbo, Salvatore Fazzotta, Leonardo Gulotta, Domenico Albano, Massimo Galia, Giorgio Romano, Antonino Agrusa

Published in: BMC Surgery | Special Issue 1/2019

Abstract

Background

laparoscopic adrenalectomy has become the standard treatment for adrenal lesions. The better clinical outcoms of laparoscopic technique are valid for treatment of small benign masses (< 5–6 cm), instead there are still open questions in literature regarding the correct management of larger lesions (> 6 cm) or in case of potentially malignant adrenal tumors. The aim of this study is to evaluate the outcomes of laparoscopic adrenalectomy in a referral surgical department for endocrine surgery.

Methods

at the University Hospital Policlinico “P. Giaccone” of Palermo between January 2010 and December 2017 we performed a total of 81 laparoscopic adrenalectomy. We created a retrospective database with analysis of patients data, morphologic and hormonal characteristics of adrenal lesions, surgical procedures and postoperative results with histological diagnosis and complications.

Results

Mean size of adrenal neoplasm was 7,5 cm (range 1.5 to 18 cm). The mean operative time was 145 min (range 75–240). In statistical analysis lenght of surgery was correlated to the lesion diameter (p < 0.05) but not with pre-operative features or histological results. 5 intraoperative complications occurred. Among these patients 4 presented bleeding and 1 a diaphagmatic lesion. No conversion to open surgery was necessary and no intraoperative blood transfusion were required. Mean estimated blood loss was 95 ml (range 50–350). There was no capsular disruption during adrenal dissection. Mean length of hospital stay was 3.7 days (range 3–6 days).

Conclusions

Laparoscopic adrenalectomy is a safe procedure with low rate of morbidity. An accurate preoperative radiological examination is fundamental to obtain a stringent patients selection. The lesion diameter is related to longer operative time and appeares as the main predictive parameter of intraoperative complications but these results are not statistically significant. On the other side secreting adrenal tumors require more attention in operative management without increased rate of postoperative complications.

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Title: Laparoscopic adrenalectomy: preoperative data, surgical technique and clinical outcomes
Authors: Giuseppe Di Buono
Salvatore Buscemi
Attilio Ignazio Lo Monte
Girolamo Geraci
Vincenzo Sorce
Roberto Citarrella
Eliana Gulotta
Vincenzo Davide Palumbo
Salvatore Fazzotta
Leonardo Gulotta
Domenico Albano
Massimo Galia
Giorgio Romano
Antonino Agrusa
Publication date: 01-04-2019
Publisher: BioMed Central
Keywords: Adrenal Cancer
Cushing's Syndrome
Endocrine Surgery
Adrenalectomy
Adrenal Cancer
Endocrine Surgery
Adrenalectomy
Published in: BMC Surgery / Issue Special Issue 1/2019
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-018-0456-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic adrenalectomy: preoperative data, surgical technique and clinical outcomes

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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