Laparoscopic Adrenalectomy: Lessons Learned from 306 Cases

Kuliš, Tomislav; Knežević, N.; Pekez, Marijeta; Kaštelan, Darko; Grković, Marija Topalović; Kaštelan, Željko

doi:10.1089/lap.2011.0376

Cited by 24 publications

(30 citation statements)

References 20 publications

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“…It is a benign tumour in the adrenal cortex composed of mixture of adipose tissue and bone marrow (haematopoietic) elements. In large series, adrenal myelolipoma comprises approximately 3-4% of primary adrenal tumour (Lam & Lo 2001, Kulis et al 2012, Shenoy et al 2015.…”

Section: Myelolipomamentioning

confidence: 99%

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Lam¹

2017

Endocrine-Related Cancer

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Adrenal lipomatous tumour is a group of adrenal tumours with a significant component of adipose tissue. According to the current World Health Organization (WHO) classification of tumours of endocrine organs, adrenal myelolipoma is the only entity amongst the group of tumours being described. In the literature, other more recently documented adrenal lipomatous tumours included 24 lipomas, 32 teratomas and 16 angiomyolipomas. Rare fatty tumours of the adrenal gland comprised liposarcoma, hibernoma, adrenocortical tumours with fat component and rare adrenal tumours with fat component. Myelolipoma comprises approximately 3% of primary adrenal tumour. It is noted more commonly in females and in the right adrenal gland. Approximately 40 bilateral myelolipomas were reported. The tumour is most frequently recorded in patients between fifth and seventh decades of life. Adrenal lipomas are often seen in males and in the right adrenal gland. They were commonly noted in patients in the sixth decade of life. The diagnosis could only be possible on examination of the surgically removed specimen. Adrenal teratomas were more common in females and with a bimodal age distribution. Slightly over 60% of the patients with adrenal teratoma are symptomatic. Adrenal angiomyolipomas were often symptomatic, more common in females and in the fifth decades of life. To conclude, adrenal lipomatous tumour is uncommon. They are often benign and non-functional. It is important to recognize the features of this group of lipomatous tumours in the adrenal gland as they are being detected on increasing incidence as a result of the wide-spread use of modern imaging modalities.

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Section: Myelolipomamentioning

confidence: 99%

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Lam¹

2017

Endocrine-Related Cancer

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“…Kulis et al [19] published his series of 306 patients using the transperitoneal lateral approach for LA. No major operative complications were noted, and postoperative complications included a pulmonary embolism and two cases of pneumonia.…”

Section: Resultsmentioning

confidence: 99%

“…The median hospitalization was 4±3.7 days (range, 2-22 days). Adrenal pathology included adenoma (n=164), pheochromocytoma (n=79), hyperplasia (n=35), metastatic carcinoma (n=22), cyst (n=9), myelolipoma (n=9), hemangioma (n=3), ganglioneuroma (n=3), and melanoma (n=2) [19].…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic Adrenalectomy; A Short Summary with Review of Literature

Chalkoo¹

2017

Arch Surg Clin Res

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“…Open adrenalectomy has been mostly replaced by LA for over a decade. Numerous studies have demonstrated the safety and efficacy of LA in different approaches [4,8]. At present, no clear advantage between the transperitoneal and retroperitoneal approaches has been shown [9].…”

Section: Discussionmentioning

confidence: 99%

“…LA has become the operative procedure of choice for most adrenal tumors [2]. Many studies have reported the efficacy and safety of LA [3,4]. The small size of adrenal glands, located in the retroperitoneal space surrounded by major intraabdominal organs and great vessels, makes LA an ideal approach.…”

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confidence: 99%

Transperitoneal laparoscopic adrenalectomy: a review and single-center experience

et al. 2014

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Background: Laparoscopic adrenalectomy (LA) is the preferred approach to adrenal gland tumors. Objective: To evaluate the perioperative and functional outcomes of transperitoneal LA. Methods: We retrospectively reviewed data of all consecutive patients who underwent transperitoneal LA at our institution between April 2000 and December 2011. Results: Two hundred two patients with mean age of 46 years were included in the study. There were 109 left, 89 right, and 4 bilateral tumors. Preoperative diagnosis included 126 aldosterone-producing adenomas (APA), 33 patients with Cushing syndrome, 19 pheochromocytomas, 20 nonfunctional tumors, and 4 adrenal metastases. Mean tumor size was 3.3 cm (range 0.4-22 cm). Mean operative time was 109 min and estimated blood loss 90 mL for unilateral adrenalectomy; and 195 min and 300 mL for bilateral adrenalectomy. Four patients with pheochromocytoma required transfusion and 2 required conversion to an open approach. Seven intraoperative complications and 18 30-day postoperative complications occurred. These included 5 major complications (Clavien-Dindo grade 3-5). Ninety-seven percent of APA patients had normal serum potassium levels after surgery. Among the patients with functioning endocrine tumors, complete resolution rate from secondary hypertension was significantly higher in the pheochromocytoma group compared with those with APA or Cushing syndrome (82% vs. 48% vs. 68% respectively, p = 0.02). Mean follow up was 35.2 months. Conclusion: LA is the treatment of choice for most adrenal gland tumors with excellent outcomes and low complication rates. There was a high chance for complete resolution of secondary hypertension after surgery for pheochromocytoma.

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Laparoscopic Adrenalectomy: Lessons Learned from 306 Cases

Abstract: Introduction: Laparoscopic adrenalectomy has become the standard of care for the surgical

Cited by 24 publications

References 20 publications

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Laparoscopic Adrenalectomy; A Short Summary with Review of Literature

Transperitoneal laparoscopic adrenalectomy: a review and single-center experience

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