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Laparoscopic adrenalectomy for large tumours: Single team experience
Abhay N Dalvi1, Pinky M Thapar, Vinaykumar B Thapar
1Department of General Surgery, Seth G. S. Medical College and King Edward VII Memorial Hospital, Mumbai, Maharashtra, India.
Journal of Minimal Access Surgery
|December 19, 2012
Summary
Laparoscopic adrenalectomy (LA) is a safe and effective approach for large adrenal tumors exceeding 5 cm. This minimally invasive technique demonstrates feasibility, challenging size as a contraindication for adrenal mass removal.
Area of Science:
- Endocrine Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Laparoscopic adrenalectomy (LA) is the preferred surgical method for adrenal tumors.
- Increasing surgical expertise allows for successful laparoscopic treatment of large adrenal masses (>5 cm).
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic adrenalectomy for large adrenal masses (>5 cm) based on single-center experience.
Main Methods:
- A retrospective review of 46 laparoscopic adrenalectomies performed for adrenal lesions >5 cm between 2001 and 2010.
- Data analyzed included tumor size, location, function, operative time, blood loss, and conversion rates.
Main Results:
- The mean tumor size was 7.03 cm (range 5-15 cm) in 42 patients undergoing 46 LAs.
- Average blood loss was 112 ml, with a mean operative time of 144 minutes.
- 6.52% of patients had malignant tumors on final histology; 5 patients required conversion to open surgery.
Conclusions:
- Laparoscopic adrenalectomy is a safe and feasible option for large adrenal lesions.
- Adrenal tumor size alone should not preclude a laparoscopic approach.
- Successful LA for large masses relies on a graded surgical strategy, thorough preoperative evaluation, teamwork, and adherence to surgical principles.
