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Laparoscopic adrenalectomy for large solid cortical tumours--is it appropriate?

C Lupaşcu1, E Târcoveanu, C Bradea

  • 1First Surgical Unit, "Gr.T.Popa" University of Medicine and Pharmacy, Department of Surgery, "St. Spiridon" Hospital, Iaşi, Romania. cristian_lupascu@yahoo.com

Chirurgia (Bucharest, Romania : 1990)
|August 23, 2011
PubMed
Summary

Laparoscopic adrenalectomy is effective for large adrenal tumors (>= 7 cm) without signs of malignancy. Long-term outcomes are generally good, with mortality linked to underlying cancer, not the surgical approach.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Laparoscopic adrenalectomy is the preferred method for small adrenal tumors.
  • Its application for large adrenal tumors is less established.
  • This study evaluates outcomes for large adrenal tumors treated laparoscopically.

Purpose of the Study:

  • To assess the safety and efficacy of laparoscopic adrenalectomy for large adrenal tumors (>= 7 cm).
  • To determine the oncological outcomes and recurrence rates in patients undergoing this procedure.
  • To evaluate the impact of laparoscopic adrenalectomy on long-term patient survival.

Main Methods:

  • Retrospective review of patients who underwent laparoscopic adrenalectomy between 2002 and 2009.
  • Inclusion criteria: adrenal tumors >= 7 cm without preoperative or intraoperative malignant features.

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  • Data collected: clinical, biochemical, CT follow-up, and histopathological findings.

    • Main Results:

    • 18 patients with large adrenal tumors (mean size 7.57 cm) underwent laparoscopic adrenalectomy.
    • Histology revealed 10 adenomas, 4 malignant tumors, and 4 indeterminate tumors.
    • Three patients died from metastatic disease; one required liver resection. Fourteen patients showed no recurrence after a mean follow-up of 28.94 months.

    Conclusions:

    • Laparoscopic adrenalectomy is a viable option for adrenal tumors >= 7 cm lacking malignancy indicators.
    • The surgical approach does not appear to negatively impact long-term outcomes.
    • Patient mortality is primarily associated with the presence of malignancy, not the laparoscopic procedure itself.