TY - JOUR
T1 - Laparoscopic adrenalectomy for large adrenal masses
T2 - Pushing the envelope
AU - Boylu, Ugur
AU - Oommen, Mathew
AU - Lee, Benjamin R.
AU - Thomas, Raju
PY - 2009/6/1
Y1 - 2009/6/1
N2 - Purpose: To determine the role of laparoscopy for large adrenal tumors in terms of outcomes, pathology, operative time, and morbidity. Patients and Methods: A retrospective review of 24 patients who underwent laparoscopic adrenalectomy was performed to record the size of the lesions, surgical techniques used, operative times, estimated blood loss, duration of hospital stay, need for blood transfusion, conversion to open surgery, and complications. The laparoscopic adrenalectomy patients were divided into two groups based on tumor size: <8 cm (n = 16, group 1) and ≥8 cm (n = 8, group 2). Results: Mean tumor size was 5.6 cm for group 1 and 12.1 cm for group 2. Mean operative times were 143.12 and 188.75 minutes for groups 1 and 2, respectively. Mean estimated blood loss was 89.69 mL for group 1 and 334.38 mL for group 2. Operative time and blood loss were significantly higher in group 2. Pathologic examination revealed eight adrenal cortical adenomas, five myolipomas, four pheochromocytomas, four cysts/pseudocysts, and three adrenocortical hyperplasias. No significant difference was found between groups concerning transfusion rates, duration of hospital stay, and conversion to open surgery. Conclusion: Laparoscopic adrenalectomy is a feasible procedure for large masses but results in longer operative times and higher total blood loss when compared with results for masses smaller than 8 cm. Our findings suggest, however, that laparoscopic adrenalectomy for masses larger than 8 cm can produce comparable results concerning hospital stay, conversion to open surgery rate, and pathologic outcome in comparison with results for adrenal masses smaller than 8 cm.
AB - Purpose: To determine the role of laparoscopy for large adrenal tumors in terms of outcomes, pathology, operative time, and morbidity. Patients and Methods: A retrospective review of 24 patients who underwent laparoscopic adrenalectomy was performed to record the size of the lesions, surgical techniques used, operative times, estimated blood loss, duration of hospital stay, need for blood transfusion, conversion to open surgery, and complications. The laparoscopic adrenalectomy patients were divided into two groups based on tumor size: <8 cm (n = 16, group 1) and ≥8 cm (n = 8, group 2). Results: Mean tumor size was 5.6 cm for group 1 and 12.1 cm for group 2. Mean operative times were 143.12 and 188.75 minutes for groups 1 and 2, respectively. Mean estimated blood loss was 89.69 mL for group 1 and 334.38 mL for group 2. Operative time and blood loss were significantly higher in group 2. Pathologic examination revealed eight adrenal cortical adenomas, five myolipomas, four pheochromocytomas, four cysts/pseudocysts, and three adrenocortical hyperplasias. No significant difference was found between groups concerning transfusion rates, duration of hospital stay, and conversion to open surgery. Conclusion: Laparoscopic adrenalectomy is a feasible procedure for large masses but results in longer operative times and higher total blood loss when compared with results for masses smaller than 8 cm. Our findings suggest, however, that laparoscopic adrenalectomy for masses larger than 8 cm can produce comparable results concerning hospital stay, conversion to open surgery rate, and pathologic outcome in comparison with results for adrenal masses smaller than 8 cm.
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U2 - 10.1089/end.2008.0555
DO - 10.1089/end.2008.0555
M3 - Article
C2 - 19456243
AN - SCOPUS:67749084368
SN - 0892-7790
VL - 23
SP - 971
EP - 975
JO - Journal of Endourology
JF - Journal of Endourology
IS - 6
ER -