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Laparoscopic surgery is safe for large adrenal lesions
P S H Soon1, M W Yeh, L W Delbridge
1University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Summary
Laparoscopic adrenalectomy is safe for large adrenal tumors (≥60 mm) without signs of malignancy. This approach shows no short-term recurrence, supporting its use for potentially malignant large adrenal tumors.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Endocrinology
Background:
- Laparoscopic adrenalectomy is the preferred method for benign adrenal lesions.
- The safety of laparoscopic adrenalectomy for large adrenal tumors (≥60 mm) is debated due to increasing adrenocortical carcinoma prevalence with tumor size.
Purpose of the Study:
- To evaluate the safety and outcomes of laparoscopic adrenalectomy for large adrenal tumors (≥60 mm).
Main Methods:
- Retrospective cohort study of 170 patients with 173 adrenal tumors (1995-2005).
- Analysis of outcomes for tumors ≥60 mm, comparing open and laparoscopic adrenalectomy approaches.
Main Results:
- 29 tumors were ≥60 mm; 16 underwent laparoscopic adrenalectomy.
- 8 adrenocortical carcinomas were identified in the large tumor group.
- Laparoscopic adrenalectomy for large tumors without malignancy signs showed no short-term recurrence, with patients alive and disease-free.
Conclusions:
- Laparoscopic adrenalectomy is a safe option for large adrenal tumors (≥60 mm) when malignancy is not evident preoperatively or intraoperatively.
- Findings support the use of laparoscopic adrenalectomy for potentially malignant large adrenal tumors lacking preoperative or intraoperative signs of cancer.
