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Open Access 01-12-2015 | Research article

Laparoscopic transperitoneal lateral adrenalectomy for malignant and potentially malignant adrenal tumours

Authors: Michał Pędziwiatr, Mateusz Wierdak, Michał Natkaniec, Maciej Matłok, Magdalena Białas, Piotr Major, Piotr Budzyński, Alicja Hubalewska-Dydejczyk, Andrzej Budzyński

Published in: BMC Surgery | Issue 1/2015

Abstract

Background

Laparoscopic adrenalectomy is still controversial in cases where malignancy is suspected. However, many proponents of this technique argue that in the hands of an experienced surgeon, laparoscopy can be safely performed. The aim of this study is to present our own experience with the application of laparoscopic surgery for the treatment of malignant and potentially malignant adrenal tumours.

Methods

Our analysis included 52 patients who underwent laparoscopic adrenalectomy in 2003–2014 due to a malignant or potentially malignant adrenal tumour. Inclusion criteria were primary adrenal malignancy, adrenal metastasis or pheochromocytoma with a PASS score greater than 6. We analyzed the conversion rate, intra- and postoperative complications, intraoperative blood loss and R0 resection rate. Survival was estimated using the Kaplan-Meier method.

Results

Conversion was necessary in 5 (9.7 %) cases. Complications occurred in a total of 6 patients (11.5 %). R0 resection was achieved in 41 (78.8 %) patients and R1 resection in 9 (17.3 %) patients. In 2 (3.9 %) cases R2 resection was performed. The mean follow-up time was 32.9 months. Survival depended on the type of tumour and was comparable with survival after open adrenalectomy presented in other studies.

Conclusions

We consider that laparoscopic surgery for adrenal malignancy can be an equal alternative to open surgery and in the hand of an experienced surgeon it guarantees the possibility of noninferiority. Additionally, starting a procedure with laparoscopy allows for minimally invasive evaluation of peritoneal cavity. The key element in surgery for any malignancy is not the surgical access itself but the proper technique.

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Title: Laparoscopic transperitoneal lateral adrenalectomy for malignant and potentially malignant adrenal tumours
Authors: Michał Pędziwiatr
Mateusz Wierdak
Michał Natkaniec
Maciej Matłok
Magdalena Białas
Piotr Major
Piotr Budzyński
Alicja Hubalewska-Dydejczyk
Andrzej Budzyński
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Surgery / Issue 1/2015
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-015-0088-z

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Laparoscopic transperitoneal lateral adrenalectomy for malignant and potentially malignant adrenal tumours

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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