Laparoscopic adrenalectomy: Our clinical experiences with the first 10 patients

Öz

Objectives: The aim of this study is to present the results of our first ten laparoscopic adrenalectomy cases which were performed in our clinic. Materials and methods: Between December 2010 and September 2012 the standard transperitoneal laparoscopic adrenalectomy was performed on 10 patients. Data of patients such as age, weight, height, operation time, hospitalization time, complications, size of adrenal mass and pathological diagnosis were retrospectively reviewed and recorded from the hospital records. Results: Three of ten patients were male and seven of them were female. The mean age of the patients was 42.12 ± 11.4 (21-55) years. Mean operation time was recorded as 136 ± 23.6 (100-190) min. Mean tumor size was 7.1 ± 2.7 (5-12) cm. None of the patients required blood transfusion. Mean hospital stay was 2.3 ± 1.2 (2-6) days. Pathological diagnoses of masses were pheocromacytoma in two patients, adrenal adenoma in six, myelolipoma in one and pseudocist in one. Conclusions: According to our experience with the limited number of the first ten cases, transperitoneal laparoscopic adrenalectomy is a safe and effective treatment modality, associated with minimal morbidity. To obtain more reliable information larger series with long-term results of laparoscopic adrenalectomy is needed.

Anahtar Kelimeler

• Laparoscopy, adrenalectomy, experience, transperitoneal

Laparoskopik adrenalektomi: İlk 10 hastadaki deneyimlerimiz

Öz

Amaç: Bu çalışmanın amacı kliniğimizde uygulanan ilk on laparoskopik adrenalektomi vakalarının sonuçlarını sunmaktır. Gereç ve yöntem: Eylül 2010-Aralık 2012 tarihleri arasında on hastaya standart laparoskopik transperitoneal adrenalektomi uygulandı. Yaş, kilo, boy, ameliyat süresi, komplikasyonlar, yatış süresi, kitle boyutu ve patolojik tanıları gibi hastalara ait bilgiler hastane kayıtlarından tarandı ve kaydedildi Bulgular: 10 hastanın 3\'ü erkek, 7\'si kadın idi. Hastaların ortalama yaşı 42,12 ± 11,4 yıl (21-55) idi. Ortalama operasyon süresi 136 ± 23,6 (100-190) dakika idi. Ortalama tümör boyutu 7,1 ± 2.7 (5-12) cm idi. Hiçbir hastada postoperatif transfüzyon gereksinimi olmadı. Ortalama hastanede kalış süresi 2,3 ± 1,2 (2-6) gün idi. Kitlelerin patolojik tanısı altı hastada adrenal adenom, iki hastada feokromasitoma, bir hastada miyelipom, bir hastada pseudokist idi. Sonuç: Sınırlı sayıdaki ilk on vakalık tecrübemize göre laparoskopik adrenalektomi güvenli, etkin ve morbiditesi düşük bir tedavi seçeneğidir. Daha güvenilir bilgiler elde edilebilmek için laparoskopik adrenalektomi sonrası uzun dönem sonuçların ortaya konduğu geniş serilere ihtiyaç vardır.

Anahtar Kelimeler

• laparoskopi, adrenalektomi, tecrübe, transperitoneal

Kaynakça

1. Gagner M, Lacroix A, Bolte E. Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma. New Engl J Med 1992;327(14):1033.
2. Gill IS: The case for laparoscopic adrenalectomy. J Urol 2001;166(2):429-36.
3. Smith CD, Weber CJ, Amerson JR. Laparoscopic adrenalecto- my: New gold standard. World J Surg 1999;23(4):389-96.
4. Carnaille B: Adrenocortical carcinoma: which surgical ap- proach? Langenbeck’s archives of surgery / Deutsche Gesell- schaft fur Chirurgie 2012, 397(2):195-9.
5. Simforoosh N, Majidpour HS, Basiri A, et al. Laparoscopic adrenalectomy: 10-year experience, 67 procedures. Urology 2008;5(1):50-4.
6. Bhat HS, Nair TB, Sukumar S, et al. Laparoscopic adrenalec- tomy is feasible for large adrenal masses>6 cm. Asian J Surg 2007;30(1):52-6.
7. Duh QY, Siperstein AE, Clark OH, et al. Laparoscopic adrenal- ectomy. Comparison of the lateral and posterior approaches. Arch Surg 1996;131(8):870-6.
8. Greco F, Hoda MR, Rassweiler J, et al. Laparoscopic adrenal- ectomy in urological centres - the experience of the German Laparoscopic Working Group. BJU Int 2011;108(10):1646-51.

9. Strebel RT, Muntener M, Sulser T. Intraoperative complications of laparoscopic adrenalectomy. World J Urol 2008;26(6):555-60.
10. Park HS, Roman SA, Sosa JA: Outcomes from 3144 adrenalec- tomies in the United States: which matters more, surgeon vol- ume or specialty? Arch Surg 2009;144(11):1060-7.
11. Assalia A, Gagner M: Laparoscopic adrenalectomy. British J Surg 2004;91(10):1259-74.
12. Brunaud L, Kebebew E, Sebag F, et al. Observation or laparo- scopic adrenalectomy for adrenal incidentaloma? A surgical decision analysis. Med Science Monitor 2006;12(9):CR355-62.
13. Jacobsen NE, Campbell JB, Hobart MG. Laparoscopic versus open adrenalectomy for surgical adrenal disease. Can J Urol 2003;10(5):1995-9.
14. Lezoche E, Guerrieri M, Feliciotti F, et al. Anterior, lateral, and posterior retroperitoneal approaches in endoscopic adrenalec- tomy. Surg Endoscopy 2002;16(1):96-9.
15. Chan JE, Meneghetti AT, Meloche RM, et al. Prospective com- parison of early and late experience with laparoscopic adrenal- ectomy. Am J Surg 2006;191(5):682-6.