Laparoscopic transperitoneal adrenalectomy for adrenal tumours of 6 cm or greater: A single-centre experience

Öz, Bahadır; Cucuk, Omer Cenk; Gök, Mustafa; Akçan, Alper; Sözüer, Erdoğan

doi:10.4103/jmas.jmas_217_22

Cited by 1 publication

(1 citation statement)

References 30 publications

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“…Tumor size significantly impacts operative time, with larger masses associated with prolonged procedures ( 28 ). Tumor size, particularly when ≥8 cm, was a significant factor impacting operative time, as concluded by Öz et al , a longer operative time for masses ≥8 cm compared to smaller masses ( 31 ). Diagnosing pheochromocytoma further contributes to extended operative times ( 41 ).…”

Section: Discussionmentioning

confidence: 83%

Feasibility of laparoscopic adrenalectomy in adrenal masses greater than 5 centimeters: a systematic review and meta-analysis

Alzelfawi,

Almajed,

Alhindawi

et al. 2024

Gland Surg

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Background Laparoscopic adrenalectomy (LA) has emerged as the primary treatment for adrenal masses. This systematic review and meta-analysis assessed LA’s feasibility, safety, effectiveness, and complications for adrenal masses exceeding 5 cm. Methods The study was conducted using PRISMA guidelines with PROSPERO registration No. CRD42023462901. Adults with unilateral adrenal masses >5 cm who underwent unilateral LA were included. Intraoperative and postoperative measurements and complications were assessed. A systematic literature review employed a comprehensive search strategy which was last searched on September 8, 2023, through PubMed, Google Scholar, Web of Science, and ProQuest databases. Meta-analysis was utilized to analyze the outcomes. Risk of bias was assessed using the Newcastle-Ottawa scale. Results This systematic review encompassed 25 studies involving 963 patients who underwent LA. Tumor size varied 7.05 cm [95% confidence interval (CI): 6.24–7.70], with 50% on the right and 45% on the left. The subgroup meta-analysis comparing the transperitoneal and retroperitoneal approaches revealed the transperitoneal approach h was utilized for the largest tumor size with a mean of 12.10 cm (95% CI: 11.30–12.96), compared to the retroperitoneal approach 5.83 cm (95% CI: 5.52–6.14). Notably, the mean operative time across studies was 137.4 minutes (95% CI: 113.36–150.94), bleeding prevalence was 0.02% (95% CI: 0.01–0.03%), and average blood loss was 110.6 mL (95% CI: 78.2–156.3). Postoperative complications such as pulmonary edema, pulmonary embolism, gastric dysfunction, and wound infection were very low, ranging from 0.03% to 0.4%. Out of 963 patients, only 49 were converted to open surgery. Patient hospital stay averaged 3.72 days (95% CI: 2.97–4.66); blood transfusion was required in 1.3% (95% CI: 0.30–8.88%). Conclusions The feasibility and safety of LA for tumors exceeding 5 cm in size have notable implications for intraoperative and postoperative outcomes. Underreporting in the included studies may impact the generalizability of findings.

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Section: Discussionmentioning

confidence: 83%