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Laparoscopic adrenal surgery in children: Lessons from a single centre experience
Sudhir Sukumar1, Santosh Jadhav, Balagopal Nair
1Department of Urology, Amrita Institute of Medical Sciences and Research Centre, Kochi, India.
Purpose:
Although commonly performed in adults, laparoscopic adrenalectomy in children is performed only in centres with advanced laparoscopic expertise.
Materials And Methods:
This is a retrospective analysis of laparoscopic adrenalectomies performed at a single centre between January 2003 and May 2010. After preoperative evaluation with biochemical assays and radiologic imaging, surgery was performed by using the lateral transabdominal approach in all patients.
Results:
Ten laparoscopic adrenalectomies (including three bilateral) were performed in seven children, with a mean age of 9.6 years. The tumours ranged from 2 - 7 cms in size. The operative durations were 75 - 130 minutes (unilateral) and 250 - 270 minutes (bilateral). Operative blood loss was minimal. There were no open conversions, but terminal hand assistance was required in one large right pheochromocytoma. The postoperative hospital stay ranged from 3 - 10 days. The final pathological diagnoses included pheochromocytoma, hyperplasia and neuroblastoma. Follow-up at 24 - 87 months was uneventful.
Conclusion:
With adequate experience in laparoscopy, it is possible to perform adrenalectomy in selected children.
