ARTICOLI ORIGINALI   

Minerva Chirurgica 2014 April;69(2):59-64

Copyright © 2014 EDIZIONI MINERVA MEDICA

lingua: Inglese

Laparoscopic adrenalectomy for large adrenal masses: a challenge or a routine?

Maestroni U. ¹, Vicente D. ², Del Rio P. ¹, Ziglioli F. ¹, Dinale F. ¹, Campobasso D. ¹, Ferretti S. ¹, Stojadinovic A. ^3-5, Avital I. ^{4, 5} ✉

¹ Department of Surgery, University Hospital of Parma, Parma, Italy; ² Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA; ³ United States Military Cancer Institute, Bethesda, MD, USA; ⁴ Uniformed Services University of the Health Sciences, Bethesda, MD, USA; ⁵ Bon Secours Cancer Institute, Richmond, VA, USA

AIM: The increased incidence of malignancy and the concern for higher rate of complications with laparoscopic resection of larger tumors typically limits laparoscopic adrenalectomy to small adrenal masses. We used our prospectively collected database to compare laparoscopic adrenalectomy outcomes between small and large adrenal tumors.
METHODS: Operative details and outcomes were compared by adrenal mass size size: Group A≤4 cm and Group B>4 cm, for consecutive laparoscopic adrenalectomies performed between 2009 and 2013.
RESULTS: Group A (N.=50) and Group B (N.=27) subjects had similar operative times (131 vs. 132 min, P=0.48). Group B subjects were older, had more adrenal malignancies, and had a higher blood loss with a slightly larger change in hemoglobin than Group A subjects; however, no subject required blood transfusion and complication rates were similar between groups (4% vs. 11%, P=0.34). One subject from each group required conversion to open adrenalectomy.
CONCLUSION: Laparoscopic adrenalectomy can be performed safely for adrenal masses >4 cm and size is not a contraindication to the laparoscopic approach.