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

Toutounchi, Sadegh; Pogorzelski, Ryszard; Legocka, Małgorzata; Krajewska, Ewa; Celejewski, Krzysztof; Ambroziak, Urszula; Gałązka, Zbigniew

doi:10.5114/wiitm.2018.77706

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…It is widely documented in the literature that previous abdominal operations were not associated with surgery time of laparoscopic adrenalectomy [ 16 , 33 , 34 ], in agreement with our series.…”

Section: Discussionsupporting

confidence: 93%

A Retrospective Study of 881 Lateral Transabdominal Laparoscopic Adrenalectomies Performed Between 1997 and 2017 at a Single Center in Poland to Determine Factors Associated with Surgery Time

et al. 2022

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Background Laparoscopic adrenalectomy is acknowledged as a standard procedure in adrenal lesions management. This retrospective study of lateral transabdominal laparoscopic adrenalectomy performed between 1997 and 2017 in a single center in Poland aimed to determine the factors associated with surgery time. Material/Methods This retrospective study involved 881 patients. The factors identified as potentially affecting surgery time were age, sex, side of the lesion, histopathological type, hormonal activity, size of the lesion, history of previous abdominal operations, presence of intra-abdominal adhesions, and obesity. The following statistical tests were conducted: t test, Mann-Whitney U test, Kruskal-Wallis H test, Pearson correlation test, and multivariate regression modeling. Results The mean surgery time for all operations was 139 min (55–320 min). We observed statistically significant differences for surgery time in the following groups: sex, side of the lesion, presence of intra-abdominal adhesions, obesity, histopathological type, and hormonal activity ( P <0.05). The multivariate regression model showed factors affecting surgery time were: sex, side of the lesion, size of the lesion, obesity, histopathological type (nodular hyperplasia and adenoma), and hormonal activity (non-functioning and aldosterone-secreting tumors) ( P <0.05). There was no correlation between surgery time and patient age and tumor size ( P <0.05). Mean tumor size was 42 mm (6–130 mm). Conclusions The 20-year experience of laparoscopic adrenalectomy performed at a single center showed that surgery duration was significantly longer in male patients, obese patients, left-sided adrenal tumors, tumors >6 cm in diameter, patients with a diagnosis of pheochromocytoma, and when intra-abdominal adhesions were present.

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Section: Discussionsupporting

confidence: 93%

A Retrospective Study of 881 Lateral Transabdominal Laparoscopic Adrenalectomies Performed Between 1997 and 2017 at a Single Center in Poland to Determine Factors Associated with Surgery Time

et al. 2022

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“…In case of a close proximity of the pancreatic tail LUS enables to find the correct plane of dissection. LUS is extremely useful in patients after previous upper abdominal surgery when the anatomical planes may be changed but some authors do not find any significant association between previous surgery and conversion rate and we also did not find such significant correlation (1,30). LUS is non-invasive and non-irradiating, can be performed before, during and after dissection and repeated as many times as needed without negative impact on the patient and operating staff (31).…”

Section: Discussionmentioning

confidence: 63%

Recommendation for laparoscopic ultrasound guided laparoscopic left lateral transabdominal adrenalectomy

Sebastian

Rudnicki

2020

Gland Surg

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Background: Left sided adrenalectomy may be associated with intraoperative bleeding and conversion or injury of the pancreatic tail leading to postoperative fistula. Another problem may be the identification of adrenal mass in the case of previous upper abdominal surgery. Intraoperative laparoscopic ultrasound (LUS) enables the safe plane of dissection, identification of key structures and reduction of conversion and complication rate to the minimum.Methods: Laparoscopic left lateral transabdominal adrenalectomy (LTA) was performed in 94 patients. LUS was performed in 50 patients with identification of adrenal mass, its vascularization and surrounding anatomical planes.Results: Laparoscopic left LTA with LUS was associated with significant shorter operating time, smaller rate of conversions and intraoperative bleeding in comparison to the group without intraoperative ultrasound.Conclusions: Intraoperative ultrasound during laparoscopic left LTA is a very effective method of navigation and its use should be taken into consideration especially in cases when the visualization and possibility of safe dissection are reduced.

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“…But they also reported increased operative time, intra-operative blood loss, and hospital LOS with large lesions [32]. Toutounchi et al, in their series, evaluated patients undergoing lateral laparoscopic adrenalectomy with previous abdominal surgery, and reported that the size of the tumor was a reason for conversion [33]. In our series, intraoperative blood loss, rate of conversion and hospital stay were similar between groups (p = 0.23, p = 0.18 and p = 0.07 respectively).…”

Section: Discussionmentioning

confidence: 99%

Transperitoneal laparoscopic surgery in large adrenal masses.

Şahbaz

Dural

Akarsu

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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Introduction: The laparoscopic adrenalectomy (LA) has become the gold standard since the transperitoneal laparoscopic approach was first reported. Aim: To evaluate the applicability, safety and short-term results of laparoscopic surgery in adrenal masses over 6 cm. Material and methods: Demographic data, hormonal activities, imaging modalities, operative findings, operation time, conversion rates, complications, duration of hospital stay and histopathologic results of 128 patients who underwent laparoscopic adrenalectomy were evaluated retrospectively. Patients included in the learning curve (n = 23), robotic surgery cases (n = 15) and patients with suspected metastasis (n = 4) were excluded from the study. Six cm mass size was taken as a reference and two groups were formed (group 1: < 6 cm, group 2: ≥ 6 cm). The results of the two groups were compared. Results: There were 64 cases in group 1 and 22 cases in group 2. Functional mass ratio and mass sides were similar between the groups (p = 0.30 and p = 0.17, respectively). The mean mass size in group 1 was 36.4 ±11.2 mm and in group 2 82.4 ±15.5 mm. The conversion rate was similar between the two groups (p = 0.18). The duration of surgery was 135.5 ±8.29 min in group 1, 177.0 ±14.9 min in group 2 (p = 0.014). Morbidity and lengths of hospital stay were similar (p = 0.76, p = 0.34 respectively). Adrenocortical carcinoma was detected in three cases in group 1, which were completed laparoscopically, and in two cases in group 2, which were converted to open surgery (p = 0.46). Conclusions: Although open surgery is still recommended in the guidelines, studies are now being carried out to ensure that laparoscopy can be safely performed on masses over 6 cm. There was no difference between short-term follow-up and histopathologic results in our study.

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

Cited by 3 publications

References 18 publications

A Retrospective Study of 881 Lateral Transabdominal Laparoscopic Adrenalectomies Performed Between 1997 and 2017 at a Single Center in Poland to Determine Factors Associated with Surgery Time

A Retrospective Study of 881 Lateral Transabdominal Laparoscopic Adrenalectomies Performed Between 1997 and 2017 at a Single Center in Poland to Determine Factors Associated with Surgery Time

Recommendation for laparoscopic ultrasound guided laparoscopic left lateral transabdominal adrenalectomy

Transperitoneal laparoscopic surgery in large adrenal masses.

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