Our experience of laparoscopic partial adrenalectomy in surrenal adenomas

Abstract

Aim: For adrenal lesions which are functional and bigger than four centimeters, the optional therapy is surgery. Laparoscopy for the surgery of adrenal masses is increasingly used today. In the past, total adrenalectomy was performed for any adrenal lesions without any exception; however, bilateral involvement of tumors like pheochromocytoma causes trouble and forced surgeons to try partial adrenalectomy. Recently, partial adrenalectomy is a routine surgical procedure for bilateral lesions and also becoming common for unilateral lesions. We aimed to present short-term results for patients who undergo laparoscopic total or partial adrenalectomy.
 Material and Method: We collect data retrospectively for 33 patients who were operated on in our clinic for adrenal mass between January 2010 and December 2014. 3 patients were excluded from the study. All data were gained from personal patient medical records. Follow-up records were noted with one-by-one interviews by questioning steroid usage and symptoms of adrenal insufficiency.
 Results: Patients were divided into two groups as total adrenalectomy group with 19 patients and partial adrenalectomy group with 11 patients. All patients who underwent total adrenalectomy have unilateral lesions, while 4 for 11 partial adrenalectomy patients have bilateral adrenal masses. Adrenal insufficiency developed in 3 patients for total adrenalectomy, 1 patient for unilateral partial adrenalectomy, and 1 patient for bilateral partial adrenalectomy.
 Conclusion: Partial adrenalectomy appears to be protective for adrenal insufficiency for bilateral cases with a ratio of 75%. there was no significant difference between the total or partial unilateral adrenalectomy group, considering postoperative complications, recurrence rates, and insufficiency. As a result, laparoscopic partial adrenalectomy has similar results with less morbidity for unilateral lesions and an alternative method with less adrenal insufficiency for bilateral lesions. Laparoscopic partial adrenalectomy could be performed safely after the learning period was completed and should be considered for adrenal surgeries.