Transperitoneal laparoscopic adrenalectomy

2011 
Abstract Objectives To present our results with transperitoneal laparoscopic adrenalectomy after completion of 70 procedures. Materials and methods Between July 2002 and December 2010, transperitoneal laparoscopic adrenalectomy was performed in 70 patients with the following diagnoses: Conn syndrome (22 cases), nonfunctioning adenomas (18), Cushing syndrome (10), pheochromocytomas (7), myelolipomas (4), metastasis after treatment of primary nonadrenal tumors (6), ganglioneuroma (1), adrenal gland hematoma (1) and adrenal carcinoma (1). We describe the size, surgical and hospitalization times, blood loss, need for transfusion, surgical complications and rate of conversion to open surgery. Results Of 70 patients, 35 were men and 35 women (1:1) with a mean age of 58.2 years (range, 82.2–29.1). The most common site was left (58%) compared to right (42%). The mean size of the surgical specimen was 5.11 cm, mean surgical time was 119.2 min (50–240) and mean operative bleeding was 140.6 (30–800) cm 3 . Only 3 patients required blood transfusion. The mean time until oral feeding was 17 h, and the mean hospital stay was 4.3 (2–15) days. Complications were 2 cases of surgical infections, 1 of prolonged paralytic ileus, and 1 of splenic laceration and 1 of intestinal perforation, which both required reconversion to open surgery (4.28%). Conclusions Laparoscopic adrenalectomy is a safe procedure, with a low percentage of complications and a short hospital stay. The choice of this approach will depend on the surgeon's experience with the lesion etiology and size in each case.
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