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Laparoscopic adrenal surgery in children.
Lísias N Castilho1, Octavio A Castillo, Francisco T Dénes
1Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
The Journal of Urology
|June 7, 2002
Summary
Laparoscopic adrenalectomy is a feasible surgical option for select pediatric patients, demonstrating positive outcomes with minimal complications. This minimally invasive approach offers a safe alternative for children requiring adrenal gland surgery.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Endocrinology
Background:
- Laparoscopic adrenalectomy, first reported in 1992, has extensive literature in adults but limited reports in pediatric cases.
- This study addresses the scarcity of data on laparoscopic adrenal surgery in children.
Purpose of the Study:
- To review the experience and outcomes of laparoscopic adrenal surgery in a pediatric population.
- To evaluate the feasibility and safety of this minimally invasive technique in children.
Main Methods:
- A retrospective review of 13 pediatric patients (8 girls, 5 boys; age ≤15 years) who underwent laparoscopic adrenalectomy between 1994 and 2001.
- Patients presented with various conditions including virilizing tumors, nonfunctioning adrenal tumors, Cushing's syndrome, pheochromocytoma, and Cushing's pituitary disease.
- Preoperative assessment included computerized tomography to evaluate unilateral adrenal lesions.
Main Results:
- Two procedures (15.4%) required conversion to open surgery; no deaths or postoperative complications were reported.
- Average operative time for nonconverted unilateral procedures was 107 minutes, with one patient (7.7%) requiring a blood transfusion.
- Average hospital stay was 5.5 days, with a mean follow-up of 16 months. Diagnoses included virilization, Cushing's syndrome, pheochromocytoma, neuroblastoma, and others.
Conclusions:
- Laparoscopic adrenalectomy is a feasible and effective surgical option for carefully selected pediatric patients.
- The procedure demonstrates positive outcomes and a favorable safety profile in this cohort.