Our experience in laparoscopic adrenalectomy

Abstract

Purpose: Laparoscopic adrenalectomy (LA) has become the procedure of choice to treat functioning and non-functioning adrenal tumours. With improving experience, large adrenal tumours (> 5 cm) are being successfully tackled by laparoscopy.Material and methods: Thirty-five laparoscopic adrenalectomies performed in 32 patients for adrenal lesions during the period from 2006 to 2012 were analyzed.Results: Mean tumour size was 5,03 cm (range, 2-11 cm). Tumour size was larger than 8 cm in four patients. The lesions were localized on the right side in 17 patients and on the left one in 15 patients while bilateral tumours were established in three patients. Functioning tumours were present in 22 out of 32 patients. Average blood loss was 112 mL (range, 20-400 mL) with the mean operating time being 144 min (range, 45-270 min). Three patients underwent conversion to open procedure. Final histology revealed malignant tumours in three of 32 patients (9,52%).Conclusion: LA is safe and feasible for large adrenal lesions. Mere size should not be considered as a contraindication to laparoscopic approach in large adrenal masses. Graded approach, perfect preoperative assessment and planning, team work and adherence to anatomical and surgical principles are the key to success