LAPAROSCOPIC SURGICAL TREATMENT FOR ADRENAL TUMORS, A RETROSPECTIVE ANALYSIS
Date Issued
2022
Author(s)
Sasho Dohchev
Sotir Stavridis
Bashkim Shabani
Dimitar Trajkovski
Aleksandar Trifunovski
Slobodan Gurmeshevski
Asim Musa
Zivko Popov
DOI
10.20903/zpopov-2022-0008
Abstract
Objective. Laparoscopic adrenalectomy has rapidly replaced open
adrenalectomy as the procedure of choice for benign adrenal tumors. The
aim of this study was to evaluate the long-term results of 105 consecutive
laparoscopic and open adrenalectomies performed during a period of 14.5
years at the University Clinic of Urology in Skopje. We aimed to present
our experience with this procedure. In addition, we compare the clinical
outcomes of laparoscopic (LA) vs. the open adrenalectomies (OA) performed
at our institution.
Patients and methods: A retrospective analysis of patients operated
on for adrenal tumors was conducted. From May 2005 to August 2020, one
hundred adrenalectomies were performed on 105 patients since laparoscopic
adrenal surgery was introduced in our country. There were 48 men and 57
women, aged 23 to 73 years. All patients were assessed regarding their
demographic data, hormonal status, operative time, estimated blood loss, complications, size of the tumor, number of patients requiring blood
transfusion, hospital stay and conversion to open surgery for LA.
Results: In 93 patients, the laparoscopic procedure was completed
successfully. In 12 cases, the laparoscopic procedure was converted to an
open one. Operative time for laparoscopic adrenalectomies ranged from 45
to 120 minutes. The average postoperative hospital stays for laparoscopic
adrenalectomy ranged from 1 to 2 days (1.5 days), versus 5 to 20 days for
patients who underwent the open or converted procedure. LA proved
superior to OA, resulting in less estimated blood loss, shorter operating time,
shorter time to resumption of oral intake, shorter postoperative hospital
stay and less analgesic requirements. During the follow-up of 3 to 96
months, no tumor recurrence and/or metastasis developed.
Conclusions: Laparoscopic adrenalectomy should be the treatment of
choice for all benign adrenal tumors. Laparoscopic resection of large
adrenal tumors necessitates experience in open and advanced laparoscopic
surgery. Our results concur with other retrospective reviews comparing
laparoscopic and open adrenalectomy, demonstrating unequivocal advantages
in terms of reduced length of hospital stay, blood loss, return of bowel
function, functional recovery, and post-operative morbidity
adrenalectomy as the procedure of choice for benign adrenal tumors. The
aim of this study was to evaluate the long-term results of 105 consecutive
laparoscopic and open adrenalectomies performed during a period of 14.5
years at the University Clinic of Urology in Skopje. We aimed to present
our experience with this procedure. In addition, we compare the clinical
outcomes of laparoscopic (LA) vs. the open adrenalectomies (OA) performed
at our institution.
Patients and methods: A retrospective analysis of patients operated
on for adrenal tumors was conducted. From May 2005 to August 2020, one
hundred adrenalectomies were performed on 105 patients since laparoscopic
adrenal surgery was introduced in our country. There were 48 men and 57
women, aged 23 to 73 years. All patients were assessed regarding their
demographic data, hormonal status, operative time, estimated blood loss, complications, size of the tumor, number of patients requiring blood
transfusion, hospital stay and conversion to open surgery for LA.
Results: In 93 patients, the laparoscopic procedure was completed
successfully. In 12 cases, the laparoscopic procedure was converted to an
open one. Operative time for laparoscopic adrenalectomies ranged from 45
to 120 minutes. The average postoperative hospital stays for laparoscopic
adrenalectomy ranged from 1 to 2 days (1.5 days), versus 5 to 20 days for
patients who underwent the open or converted procedure. LA proved
superior to OA, resulting in less estimated blood loss, shorter operating time,
shorter time to resumption of oral intake, shorter postoperative hospital
stay and less analgesic requirements. During the follow-up of 3 to 96
months, no tumor recurrence and/or metastasis developed.
Conclusions: Laparoscopic adrenalectomy should be the treatment of
choice for all benign adrenal tumors. Laparoscopic resection of large
adrenal tumors necessitates experience in open and advanced laparoscopic
surgery. Our results concur with other retrospective reviews comparing
laparoscopic and open adrenalectomy, demonstrating unequivocal advantages
in terms of reduced length of hospital stay, blood loss, return of bowel
function, functional recovery, and post-operative morbidity
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