Is tumour size a contraindication to laparoscopic adrenalectomy? Case report.

Fiszer, Patryk; Toutounchi, Sadegh; Pogorzelski, Ryszard; Krajewska, Ewa; Sutkowski, Bartosz; Gierej, Piotr; Skórski, Maciej

doi:10.5114/wiitm.2011.25931

Cited by 9 publications

(13 citation statements)

References 10 publications

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“…In our department, LTA was the only technique of minimally invasive adrenalectomy used in the analyzed period. Originally, laparoscopic adrenalectomy was indicated in patients with adrenal tumors < 5 cm in diameter, but it is now commonly used in patients with tumors > 8 cm [ 11 , 12 ]. In our study, the largest adrenal tumor removed during LTA was 9 cm in diameter.…”

Section: Discussionmentioning

confidence: 99%

Lateral laparoscopic adrenalectomy in patients with previous abdominal surgery - single-center experience.

Toutounchi

Pogorzelski

Legocka

et al. 2018

Videosurgery and Other Miniinvasive Techniques

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IntroductionLateral transabdominal adrenalectomy (LTA) is the most common minimally invasive technique used to treat patients with adrenal tumors.AimTo analyze intra-operative and post-operative complications and reasons for conversion to open surgery in patients who underwent LTA and had previous abdominal surgery.Material and methodsFive hundred and nineteen patients underwent LTA in our center between 2005 and 2016. We identified a study group of 150 patients, with previous abdominal surgery. We analyzed the frequency of intra-operative and post-operative complications and the reasons for conversion from laparoscopic to open adrenalectomy.ResultsThe patients’ mean age was 58; they underwent LTA due to hormonally active tumors (n = 79, 53%) and non-functioning adrenal tumors (n = 71, 47%). The size of adrenal lesions ranged from 20 mm to 90 mm. Seventy-eight (52%) adrenal lesions were found in the right adrenal gland, and 72 (48%) lesions in the left adrenal gland. The mean operating time was 130 min. The mean stay in hospital was five days. The intra-operative complications included blood pressure fluctuations (n = 32), abnormal vascular supply of the adrenal glands causing difficulties with dissections (n = 3), and respiratory problems (n = 1). Two (1.3%) patients had post-operative bleeding at the site of removed adrenal glands; 1 patient had an exacerbation of asthma postoperatively. Of the 150 patients analyzed, 3 (2%) required conversion to open adrenalectomy. The conversions were not caused by abdominal adhesions.ConclusionsLateral transabdominal adrenalectomy is feasible and safe in patients with previous abdominal surgery. In our study, conversion from laparoscopic to open adrenalectomy was not caused by abdominal adhesions.

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Section: Discussionmentioning

confidence: 99%

Lateral laparoscopic adrenalectomy in patients with previous abdominal surgery - single-center experience.

Toutounchi

Pogorzelski

Legocka

et al. 2018

Videosurgery and Other Miniinvasive Techniques

Self Cite

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“…Some authors consider a diameter of ≥6 cm a relative contraindication to laparoscopic adrenalectomy [3,4]. On the other hand, there are recent publications where authors report the feasibility of laparoscopic adrenalectomy of large tumors [15,16,17,18,19,20]. …”

Section: Discussionmentioning

confidence: 99%

“…Moreover, there are reports of high rate of intraoperative complications [14]. However, tumor size as a limitation for laparoscopic adrenalectomy is questioned by some authors [15,16,17,18,19,20]. …”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Transperitoneal Lateral Adrenalectomy for Large Adrenal Tumors

Natkaniec¹,

Pędziwiatr²,

Wierdak³

et al. 2016

Urol Int

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Background: Laparoscopic adrenalectomy is the gold standard for treatment of benign adrenal lesions. Tumor size is a factor that might influence decision-making concerning the use of laparoscopic approach. The aim of this study was to analyze the results of adrenalectomy for tumors ≥6 cm in diameter. Methods: Two groups of patients were analyzed: first group comprised 441 patients with tumors <6 cm in diameter and second group consisted of 89 patients with tumors ≥6 cm. Both groups were compared with regard to the duration of surgery, intraoperative blood loss, conversion and complications rate. Results: Median duration of surgery in groups 1 and 2 amounted to 86.6 and 111.9 min (p < 0.0001), respectively. Median intraoperative blood loss in groups 1 and 2 was 56.5 and 172.8 ml (p < 0.0001), respectively. There was a linear relationship between tumor size and the duration of surgery, and between tumor size and intraoperative blood loss (p < 0.0001). There were 2 (0.5%) and 6 (6.7%) conversions in groups 1 and 2, respectively. There were 41 (9.3%) and 14 (15.7%) complications in groups 1 and 2 (p = 0.0692), respectively. Conclusions: Laparoscopic adrenalectomy of tumors ≥6 cm is more difficult, but it can be regarded safe and beneficial for patients.

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“…Clinical experience shows that the presence of a malignancy with diameter greater than 10 cm qualifies for laparoscopy, but there must be no infiltration of the tumour into neighbouring tissues [7]. In the case of larger, benign tumours, not hormonally active, laparoscopic adrenalectomy in technically possible.…”

Section: Discussionmentioning

confidence: 99%

“…In literature there are many publications comparing both methods and their complications, radical oncological therapy, duration of the operation, blood loss, and hospitalisation time. In most cases, the laparoscopic method seems to be better than the open procedure [7,8]. The surgical technique must be adjusted to the patients' needs.…”

Section: Introductionmentioning

confidence: 99%

The usefulness of laparoscopic adrenalectomy in the treatment of adrenal neoplasms — a single-centre experience

Pogorzelski

Toutounchi

Krajewska

et al. 2017

Endokrynologia Polska

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Introduction: Adrenal neoplasms comprise about 10% of all tumours affecting this organ and constitute a significant, at first diagnostic and subsequently therapeutic, problem, especially since a relatively high proportion of neoplastic lesions are asymptomatic. The number of diagnosed metastases to adrenal glands is increasing. Surgical treatment involves both open surgery as well as laparoscopy. Material and methods: There were 245 adrenalectomies performed at our centre due to various indications over the past four years. In 27 (11.5%) cases neoplasms were diagnosed in the final histopahtological examination. In 11 (40.7%) cases primary adrenal cortex tumours were diagnosed, metastases from other solid organ tumours were identified in another 12 (44.4%) patients, and rarer neoplasms were diagnosed in the remaning 4 (14.8%) subjects. Cases of malignant pheochromocytoma were not included in this report.

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Is tumour size a contraindication to laparoscopic adrenalectomy? Case report.

Cited by 9 publications

References 10 publications

Lateral laparoscopic adrenalectomy in patients with previous abdominal surgery - single-center experience.

Lateral laparoscopic adrenalectomy in patients with previous abdominal surgery - single-center experience.

Laparoscopic Transperitoneal Lateral Adrenalectomy for Large Adrenal Tumors

The usefulness of laparoscopic adrenalectomy in the treatment of adrenal neoplasms — a single-centre experience

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