Laparoskopik Adrenalektomide Hormon Aktivitesi ve Malignitenin Cerrahi Parametrelere Etkisi

Yıl 2025, Cilt: 47 Sayı: 2, 176 - 185, 27.02.2025

Osman Gercek , Emre Ballı , Murat Cengizhan Atik , Veli Mert Yazar , Kutay Topal , Haşmet Sarıcı

Öz

Adrenal bezdeki tümörlerle, hormon salgılamayan benign adenomlardan, hormon salgılayan malign adrenokortikal karsinomlara kadar değişen şekillerde karşılaşılabilir. Bu çalışmada; hormon fonksiyonel olan tümörlerin, malign patolojik sonuçların ve tümör büyüklüğünün laparoskopik transperitoneal adrenalektomi uygulanan hastalarda, cerrahi ve klinik parametrelere etkisinin araştırılması amaçlanmıştır. Çalışmamıza transperitoneal laparoskopik adrenalektomi operasyonu gerçekleştirilen 63 hasta dahil edildi. Çalışmanın ilk aşamasında, hormon fonksiyonel ve hormon fonksiyonel olmayan adrenal tümörler olarak 2 grup oluşturuldu. Çalışmanın ikinci aşamasında ise histopatolojik olarak malign ve benign adrenal tümörler olarak 2 gruba ayrıldı. Her iki aşamada da hormon aktivitesinin ve malignensinin cerrahi parametrelere etkisi araştırıldı. Ortalama operasyon süresi ve intraoperatif ortalama kan kaybı malign patolojiye sahip grupta daha yüksek izlendi (sırasıyla; p=0.041, p=0.014). Conn sendromunda operasyon süresinin Cushing ve feokromositoma grubuna göre daha kısa olduğu izlendi (p=0.038). Patolojik tümör boyutu ile operasyon süresi arasında orta düzeyde pozitif bir korelasyon olduğu izlendi ve istatistiksel olarak anlamlıydı (r=0.449, p<0.001). Laparoskopik adrenalektomi operasyonunun başarısı kitlenin morfolojik ve fonksiyonel özelliklerinden etkilenmektedir. Malign kitlelerde uzamış operasyon süreleri ve artmış kanama miktarı olduğu gösterilmiştir. Operasyonu gerçekleştirecek cerrahların, kitlenin morfolojik ve fonksiyonel farklılıklarına bağlı olarak operasyon sırasında ve sonrasında farklı klinik tablolarla karşılaşabileceklerini bilmeleri önemli görünmektedir.

Anahtar Kelimeler

Laparoskopi, Adrenalektomi, Adrenokortikal Karsinom, Cushing Sendromu

The Effect of Hormone Activity and Malignancy on Surgical Parameters in Laparoscopic Adrenalectomy

Öz

Tumours of the adrenal gland can be encountered in various forms ranging from non-hormone-secreting benign adenomas to hormone-secreting malignant adrenocortical carcinomas. This study aimed to investigate the effect of hormone-functional tumours, malignant pathological results and tumour size on surgical and clinical parameters in patients undergoing laparoscopic transperitoneal adrenalectomy. A total of 63 patients who underwent transperitoneal laparoscopic adrenalectomy were included in this study. In the first stage of the study, two groups were formed as hormone-functional adrenal tumours and hormone-non-functional adrenal tumours. In the second stage of the study, the patients were histopathologically divided into 2 groups as malignant and benign adrenal tumours. The effects of hormone activity and malignancy on surgical parameters were investigated in both stages. Mean duration of operation and intraoperative blood loss were higher in the group with malignant pathology (p=0.041, p=0.014, respectively). The duration of operation was shorter in Conn's syndrome compared to the Cushing's syndrome and pheochromocytoma groups (p=0.038). There was a moderate positive correlation between pathological tumour size and duration of operation, which was statistically significant (r=0.449, p<0.001). The success of laparoscopic adrenalectomy is affected by the morphological and functional characteristics of the mass. Prolonged operation times and increased bleeding have been observed in malignant masses. It is esential for surgeons performing the operation to be aware that they may encounter varying clinical presentations both during and after the procedure, depending on the morphological and functional characteristics of the mass.

Anahtar Kelimeler

Laparoscopy, Adrenalectomy, Adrenocortical Carcinoma, Cushing

Kaynakça

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