Endocrine Abstracts

Background data: Laparoscopic adrenalectomy has became in the last decade “gold standard” for treating of adrenal tumors with diameters smaller than six cm. In addition, one should note than larger tumors or potentially malignant tumors can now also be removed laparoscopically, with virtually no complication.

Objective: The authors evaluate the effectiveness of laparoscopic adrenalectomy for a large adrenal tumors.

Methods: One hundred laparoscopic adrenal procedures over the past five years were reviewed and followed for adequacy of resection.

Results: Indications were: pheochromocytoma (n=10), aldosterone-producing adenomas (n=15), nonfunctional adenomas (n=21), cortisol-producing adenomas (n=14), Cushing’s disease (n=32) and others (n=8). Specifically, 32 patients (23 females and nine males) between 20 and 69 (median ages of 46,43 years) had tumors larger than six cm. four of these cases underwent bilateral adrenalectomy by laparoscopic approach; in five cases the surgeons preffered conversion to the open approach. Among the reasons of conversion: bleeding, local invasion (inferior vena cava, liver, diaphragm), unclear landmarks etc. Mean operative time was 114 minutes (from 25 min to 270 min, includind patients with bilateral approach). Mortality among the studied cases was zero and as postoperative complication only a bleeding from spleen (after bilateral adrenalectomy convert to open procedure because of unclear landmarks in a case of Cushing disease) can be mentioned. Patients were discharged anywere between one and 50 days (the complicated case) postoperative (median six days).

Conclusions: Laparoscopic adrenalectomy is a reasonable procedure for selected large adrenal tumors when a complete resection is technically feasible and is no evidence of local invasion.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.