Laparoscopic adrenalectomy for functioning and non‐functioning adrenal tumors: Analysis of surgical aspects based on histological types

Ku, Ja‐Lok; Yeo, Woon Geol; Kwon, Tae Gyun; Kim, Hyeon H.

doi:10.1111/j.1442-2042.2005.01203.x

Cited by 21 publications

(9 citation statements)

References 33 publications

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“…3 Meria et al reported a cure rate of 58% in 212 patients with PA (median follow-up 44 months) and Ku et al retrospectively found a cure rate of 82% for PA (median follow-up 11 months). 4,9 Lack of complete resolution of hypertension in PA might be predicted by duration of hypertension and degree of vascular remodeling. 11 Thus, comparing the series of Ku et al with our material, their patients were ten years younger (42 in median) and might therefore have had a shorter preoperative duration of hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…8 With the introduction of laparoscopic techniques for adrenalectomy, and recently also robotic-assisted devices, the frequency of adrenalectomies has increased markedly. 9 Hence, it is likely that adrenalectomy today is performed more liberally than previously, which could affect the risk/benefit ratio. Even though many previous studies have suggested that adrenalectomy for benign functional tumours is safe and has good short-term cure rates, reports on outcome after adrenalectomy in the era of robotic surgery are scarce, especially regarding long-term follow up.…”

Section: Introductionmentioning

confidence: 99%

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Long term follow-up of benign functional adrenocortical tumors in the era of robotic surgery

2012

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Long-term outcome after operation for benign functional adrenal tumours [aldosteronoma (PA), subclinical (SCS) or clinical Cushing´s syndrome (CS)] has not been reported extensively, especially not in the era of roboticassisted laparoscopic surgery why pheochromocytomas has not been included in the group of benign functional masses? We have excluded pheocromocytoma because it is well known that it is very difficult to distinguish between malignant and benign pheocromocytomas. Since our aim was to evaluate benign lesions, we excluded pheocromocytomas. The purpose of this study was to investigate the clinical outcome for patients having undergone adrenalectomy for non-malignant clinical or subclinical functional adrenocortical tumors. The records of 65 patients with benign functional adrenocortical tumors treated with laparoscopic adrenalectomy (80% robotic assisted) were surveyed retrospectively. Clinical and biochemical data were evaluated at baseline and followup data was collected by a survey distributed to referring endocrinology centers. Cure was defined both in objective measurements and in the subjective validation of the endocrinologists referring the patients for surgery. According to our definition, 83% of patients with PA were either cured (normotension without anti-hypertensive medication), or improved (better blood pressure control with equal or fewer medications). For CS, 89% of patients were cured (biochemical normalization and lack of or significant improvement in co-morbidities). With the same definition, 73% of SCS patients were cured. The endocrinologists considered 86% of PA patients, 100% of CS and 64% of SCS patients as cured. Complications were few and there was no mortality. Robotic assisted adrenalectomy provides safe and effective treatment for PA, CS and SCS. Our objective definition of cure matched the assessment of cure of the endocrinologists in patients with PA and CS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long term follow-up of benign functional adrenocortical tumors in the era of robotic surgery

2012

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“…Previously pheochromocytoma was considered to be a relative contraindication to laparoscopic surgery, but now laparoscopic adrenalectomy for pheochromocytoma has been performed successfully and reported in several series. [1617] Regarding pheochromocytoma surgery, it is important to have early stage control of the main adrenal vein, with the intention of reducing blood pressure decompensation, yet it is questionable these days. [18] Approximately 10-15% of the pheochromocytoma are malignant.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic adrenalectomy: A single center experience

et al. 2010

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AIMS:To evaluate the efficacy and safety of laparoscopic adrenalectomy in benign adrenal disorders.METHODS AND MATERIAL:Since July 2007, twenty patients have undergone laparoscopic adrenalectomy for various benign adrenal disorders at our institution. Every patient underwent contrast enhanced CT-abdomen. Serum corticosteroid levels were conducted in all, and urinary metanephrines, normetanephrines and VMA levels were performed in suspected pheochromocytoma. All the patients underwent laparoscopic adrenalectomy via the transperitoneal approach.RESULTS:The patients were in the age range of 18-57 years, eleven males and nine females, seven right, eleven left, two bilateral. The mean operative time was 150 minutes (120-180), mean hospital stay four days (3-5), mean intraoperative blood loss 150 ml and mean post-operative analgesic need was for 36 (24-72) hours. One out of twenty-two laparoscopic operations had to be converted into open adrenalectomy due to intra-operative complications.CONCLUSIONS:Laparoscopic adrenalectomy is a safe, effective and useful procedure without any major post-operative complication and is the gold standard for all benign adrenal disorders.

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“…Patients demonstrating an excess of cortisol have increased adipose tissue and some have argued that a laparoscopic approach in these patients is most appropriate. [7] In addition, patients with Cushing's syndrome have an increased rate of morbidity due to poor wound healing and increased risk of thromboembolic events. Prior to surgical intervention care must be taken to medically optimize these individuals.…”

Section: Laparoscopic Bilateral Adrenalectomymentioning

confidence: 99%

Laparoscopic adrenalectomy: Surgical techniques

Mellon¹,

Sethi²,

Sundaram³

2008

Indian J Urol

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Since its first description in 1992, laparoscopic adrenalectomy has become the gold standard for the surgical treatment of most adrenal conditions. The benefits of a minimally invasive approach to adrenal resection such as decreased hospital stay, shorter recovery time and improved patient satisfaction are widely accepted. However, as this procedure becomes more widespread, critical steps of the operation must be maintained to ensure expected outcomes and success. This article reviews the surgical techniques for the laparoscopic adrenalectomy.

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Laparoscopic adrenalectomy for functioning and non‐functioning adrenal tumors: Analysis of surgical aspects based on histological types

Cited by 21 publications

References 33 publications

Long term follow-up of benign functional adrenocortical tumors in the era of robotic surgery

Long term follow-up of benign functional adrenocortical tumors in the era of robotic surgery

Laparoscopic adrenalectomy: A single center experience

Laparoscopic adrenalectomy: Surgical techniques

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