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World Journal of Urology
Published in: World Journal of Urology 5/2008

01-10-2008 | Original Article

Whether adrenal mass more than 5 cm can pose problem in laparoscopic adrenalectomy? An evaluation of 22 patients

Authors: Ashok K. Hemal, Ashutosh Singh, Narmada P. Gupta

Published in: World Journal of Urology | Issue 5/2008

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Abstract

Objectives

To evaluate technical feasibility and analyze outcome of laparoscopic adrenalectomy (LA) for large adrenal masses more than 5 cm.

Methods

The data of 22 patients (8 men, 14 women), who underwent LA for adrenal masses >5 cm between January 1995 and July 2007 were analyzed for this study.

Results

Twenty-two patients with a mean age of 42.5 years underwent LA for large adrenal masses (>5 cm) between January 1995 and July 2007. Transperitoneal and retroperitoneal laparoscopic adrenalectomy (TPLA and RPLA) was performed in 15 and 7 patients, respectively. The mean-operative time, blood loss, tumor size and hospital stay were 149.33 and 132.1 min, 132.33 and 94.28 ml, 7.85 and 5.85 cm and 3.5 and 3.28 days, respectively. Histopathological examination of the specimen confirmed adrenal carcinoma in 5, pheochromocytoma in 14, myelolipoma in 2 and adenoma in 1 patient. Two patients of pheochromocytoma had required open conversion, one from each group (TPLA and RPLA). Three patients had postoperative complications (wound infection 1, pneumonitis with fever 1 and retroperitoneal collection 1).

Conclusions

The size of an adrenal mass on preoperative imaging studies alone should not be the primary factor in determining whether LA should be performed. LA for adrenocortical cancers could be performed safely and effectively in the selected group. Transperitoneal approach is most suitable and recommended for large adrenal tumor and adrenal carcinoma to employ laparoscopy. One approach (TP or RP) over the other also does not lead to the substantial benefits either to the patients or to the surgeon.
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Metadata
Title
Whether adrenal mass more than 5 cm can pose problem in laparoscopic adrenalectomy? An evaluation of 22 patients
Authors
Ashok K. Hemal
Ashutosh Singh
Narmada P. Gupta
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
World Journal of Urology / Issue 5/2008
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-008-0270-3

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