Laparoscopic Adrenalectomy

Barresi, Roberto

doi:10.1001/archsurg.134.2.212

Cited by 32 publications

(18 citation statements)

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“…Pheochromocytomas also carry a malignant potential, and frequently are larger than other functional adrenal tumors. Both possibilities have been proposed as a potential contraindication to laparoscopic resection [1]. As a result, laparoscopic adrenalectomy for pheochromocytoma has been viewed with some concern, and there have been few reported studies as of this writing.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic adrenalectomy for pheochromocytoma

et al. 2001

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Section: Discussionmentioning

confidence: 99%

Laparoscopic adrenalectomy for pheochromocytoma

et al. 2001

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“…Performing laparoscopic adrenalectomies in large adrenal masses (>6 cm) is still under debate because of technical limitations, longer operative time, and an increased blood loss [5][6][7][8][9][10], despite Gagner introducing this procedure for adrenal masses larger than 10 cm in 1992 [4]. Furthermore, adrenal masses >6 cm could reveal at final histopathological examination a malignant unknown lesion: in these patients the laparoscopic approach could favor the spread of neoplastic cells in the peritoneum surface.…”

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confidence: 99%

Is laparoscopic adrenalectomy safe and effective for adrenal masses larger than 7 cm?

et al. 2007

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LA for adrenal masses larger than 7 cm is a safe and feasible technique, offering successful outcome in terms of intraoperative and postoperative morbidity, hospital stay and cosmesis for patients; it seems to replicate open surgical oncological principles demonstrating similar outcomes as survival rate and recurrence rate, when adrenal cortical carcinoma were treated. The main contraindication for this approach is the evidence, radiologically and intraoperatively, of local infiltration of periadrenal tissue.

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“…Advances in minimally invasive surgery have made it possible to remove solid organs such as the adrenal gland laparoscopically [7]. The adrenal gland is particularly suitable for laparoscopic removal because of its small size and the benign nature of most adrenal tumours [8].…”

Section: Discussionmentioning

confidence: 99%

“…Controversy exists over the maximum acceptable tumour size for laparoscopic adrenalectomy [10]. Barresi and Prinz did not recommend it for lesions more than 6-8cm though masses up to 10-15 cm have been resected laparoscopically [7,11,12]. According to Gagner neoplastic potential rather than size is the crucial issue in deciding the choice of approach [2].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic adrenalectomy — a review of initial 24 consecutive patients

et al. 2007

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Aim To analyze patient demographics, pathology, surgical procedure and outcome in initial 24 consecutive patients who underwent laparoscopic adrenalectomy in our department.Methods Twenty four patients underwent laparoscopic adrenalectomy between September 2000 and August 2005. There were 12 males and 12 females with a mean age of 44.6 years ( range 25-68 years ). The indications for adrenalectomy were pheochromocytoma (13 patients), Cushing's syndrome (5 patients), myelolipoma (2 patients), adrenal cyst (2 patients), aldosteronoma (1 patient) and adrenal incidentaloma (1 patient). Nineteen of our patients with functioning adrenal tumours were prepared preoperatively for periods ranging up to 2 weeks by the endocrinologist. All laparoscopic adrenalectomies were performed via lateral transperitoneal approach using standard four-port technique. Patients with pheochromocytoma and Cushing's syndrome were monitored in the surgical intensive care unit during immediate postoperative period. The clinical and intraoperative characteristics, complications and outcomes of all patients were analyzed. ResultsThe mean operative time for laparoscopic adrenalectomy was 136 minutes. Intraoperative hypertension occurred in 8 patients. Intraoperative hypotension occurred in 2 patients. One patient required conversion due to dense adhesions and hemorrhage. Postoperative complications were seen in six patients -immediate postoperative hypotension (2 patients), features of steroid withdrawal (2 patients) and postoperative pyrexia (2 patients). Five patients with pheochromocytoma required antihypertensive drugs in the postoperative period. There was no mortality in our series.Conclusions Laparoscopic adrenalectomy is a safe operation that incorporates all the benefi ts of minimal access surgery and is associated with a satisfactory postoperative outcome . A careful preoperative preparation in functioning adrenal tumours aids in the faster recovery of these patients.

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Laparoscopic Adrenalectomy

Cited by 32 publications

References 0 publications

Laparoscopic adrenalectomy for pheochromocytoma

Laparoscopic adrenalectomy for pheochromocytoma

Is laparoscopic adrenalectomy safe and effective for adrenal masses larger than 7 cm?

Laparoscopic adrenalectomy — a review of initial 24 consecutive patients

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