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Laparoscopic adrenalectomy for cancer.
B T Heniford1, M J Arca, R M Walsh
1Carolinas Medical Center, Charlotte, North Carolina 28232, USA. theniford@carolinas.org
Seminars in Surgical Oncology
|May 20, 1999
Summary
Laparoscopic adrenalectomy is a safe and effective surgical option for adrenal cancer and metastasis. This minimally invasive technique offers good patient outcomes with low complication rates and short hospital stays.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Adrenal Gland Neoplasms
Background:
- Adrenalectomy is a surgical procedure to remove the adrenal gland.
- Metastatic cancer to the adrenal gland is a significant clinical challenge.
- Laparoscopic adrenalectomy offers potential benefits over open surgery.
Purpose of the Study:
- To review literature on laparoscopic adrenalectomy for cancer.
- To analyze patient outcomes and operative techniques in a series of laparoscopic adrenalectomies for adrenal cancer or metastasis.
Main Methods:
- A literature review was conducted.
- A retrospective analysis of 12 laparoscopic adrenalectomies in 11 patients (Oct 1996-Feb 1998) was performed.
- Data included preoperative assessment, operative details, hospital course, and postoperative follow-up.
Main Results:
- The mean patient age was 62 years; 91% of tumors were metastatic (renal cell, lung, colon, melanoma).
- Mean tumor size was 5.9 cm; operative time averaged 181 minutes with 138 cc blood loss.
- Average hospital stay was 2.3 days; one conversion to open surgery was required due to vena cava invasion. All margins were negative. One complication (9%) occurred. No local recurrences were observed at mean follow-up of 8.3 months.
Conclusions:
- Laparoscopic adrenalectomy is a feasible and safe approach for adrenal tumors, including metastases.
- The procedure is associated with acceptable operative times, minimal blood loss, and short hospital stays.
- Excellent oncological outcomes with no local recurrences were observed in this series.