The usefulness of laparoscopic adrenalectomy in the treatment of adrenal neoplasms — a single-centre experience

Abstract

Introduction: Adrenal neoplasms comprise about 10% of all tumours affecting this organ and constitute a significant, at first diagnostic and subsequently therapeutic, problem, especially since a relatively high proportion of neoplastic lesions are asymptomatic. The number of diagnosed metastases to adrenal glands is increasing. Surgical treatment involves both open surgery as well as laparoscopy. Material and methods: There were 245 adrenalectomies performed at our centre due to various indications over the past four years. In 27 (11.5%) cases neoplasms were diagnosed in the final histopahtological examination. In 11 (40.7%) cases primary adrenal cortex tumours were diagnosed, metastases from other solid organ tumours were identified in another 12 (44.4%) patients, and rarer neoplasms were diagnosed in the remaning 4 (14.8%) subjects. Cases of malignant pheochromocytoma were not included in this report.

Laparoscopic transperitoneal adrenalectomy in the large adrenal tumor from single center experience

“…Currently, LA is the first surgical treatment of choice for almost all adrenal tumors since it provides better perioperative outcomes compared to traditional open adrenalectomy [2][3][4][5][6][7]. However, LA had limitations in some groups of patients, including patients with a large adrenal tumor.…”

“…At present, laparoscopic adrenalectomy (LA) has become the standard treatment for all small adrenal tumors since first being introduced in 1992 by Gagner et al [1]. The superiority of LA has resulted in less postoperative pain, decreased length of hospital stay, and better cosmetic results compared to open adrenalectomy [2][3][4][5][6][7]. The only specific contraindications for LA are adrenocortical carcinoma (ACC) that have radiologic evidence of tumor invasion to the periadrenal tissue, the local recurrent tumor of a previously resected adrenal mass, and patients with severe cardiopulmonary disease [8].…”

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

“…The European Society of Endocrine Surgeons published a consensus statement recommending that adrenal surgery should be performed only in centers performing at least 6 adrenalectomies per year [ 8 ]. The biggest series of patients operated on in a single institution and reported in the literature are 653 laparoscopic adrenalectomies over 24 years in the United States, 520 laparoscopic adrenalectomies over 20 years in France, 560 retroperitoneoscopic adrenalectomies over 12 years in Germany, and 245 laparoscopic adrenalectomies over 4 years in Poland [ 9 – 12 ].…”

Feasibility and Safety of Laparoscopic Transperitoneal Adrenalectomy in Large Adrenal Tumor From 20 Years Single-center Experiences- A Retrospective Cohort Study

“…At present, laparoscopic adrenalectomy (LA) has become the standard treatment for all small adrenal tumors since rst being introduced in 1992 by Gagner et al [1]. The superiority of LA has resulted in less postoperative pain, decreased length of hospital stay, and better cosmetic results compared to open adrenalectomy [2][3][4][5][6][7]. The only speci c contraindications for LA are adrenocortical carcinoma (ACC) that have radiologic evidence of tumor invasion to the periadrenal tissue, the local recurrent tumor of a previously resected adrenal mass, and patients with severe cardiopulmonary disease [8].…”

“…Subgroup analysis perioperative outcomes of patient in group 2 (tumor ≥ 6 cm) is the rst surgical treatment of choice for almost all adrenal tumors since it provides better perioperative outcomes compared to traditional open adrenalectomy[2][3][4][5][6][7]. However, LA had limitations in some groups of patients, including patients with a large adrenal tumor.…”