A 10-year single-center experience with surgical management of adrenal myelolipoma

The purpose is to report our 10-year experience with surgical management of large or symptomatic adrenal myelolipoma.

Patients receiving surgical treatment for adrenal myelolipoma between December 2001 and September 2011 in our institution were retrospectively reviewed. Patients were divided into two groups: open surgery and laparoscopic surgery. Patient demographic data, lesion size evaluated by computed tomography scan or magnetic resonance imaging, operation time, blood loss, time of returning to diets, perioperative complications, and length of hospital stay were collected and analyzed.

Forty patients (14 received open surgery and 26 received laparoscopic surgery) were enrolled in our study. Both procedures were successful and no patient in the retroperitoneal laparoscopic group required conversion to open surgery. The mean age of the patients was 52.7 years. The median size of the tumor was 5.0 cm. Forty-three percent of patients suffered from lumbago. There was no statistical difference in perioperative complications between the two groups (p>0.05). Retroperitoneal laparoscopic adrenalectomy patients had a shorter operation time (90.66±37.97 min vs 141.82±62.78 min, p=0.017), less blood loss (150, 100-200 mL vs 450, 300-525 mL, p=0.000), earlier time of returning to diets (2, 2-3 days vs 3, 2-4.5 days, p=0.036), and a shorter hospital stay (6, 5-7 days vs 10, 8-11.25 days, p=0.000) when compared with open surgery patients.

Both open and laparoscopic surgeries are efficient and safe treatments for large or symptomatic adrenal myelolipoma, and retroperitoneal laparoscopic surgery has the advantages of minimal invasion and rapid postoperative recovery.