Transperitoneal laparoscopic surgery in large adrenal masses

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Laparoscopic adrenalectomy (LA) is the established standard for adrenal gland surgery.
• The safety and efficacy of LA for larger adrenal masses (over 6 cm) require further investigation.

Purpose of the Study:

• To assess the applicability and safety of laparoscopic surgery for adrenal masses exceeding 6 cm.
• To compare short-term outcomes of laparoscopic adrenalectomy for masses < 6 cm versus ≥ 6 cm.

Main Methods:

• Retrospective analysis of 128 laparoscopic adrenalectomy cases.
• Exclusion of learning curve, robotic, and metastatic cases.
• Comparison of outcomes between masses < 6 cm (Group 1) and ≥ 6 cm (Group 2).

Main Results:

• No significant difference in conversion rates, morbidity, or hospital stay between groups.
• Surgically, longer operation times were observed for masses ≥ 6 cm (177.0 min vs. 135.5 min, p=0.014).
• Histopathology revealed similar rates of adrenocortical carcinoma in both groups.

Conclusions:

• Laparoscopic adrenalectomy is a safe and feasible option for adrenal masses over 6 cm.
• Short-term follow-up and histopathologic results are comparable between smaller and larger adrenal masses treated laparoscopically.
• Current guidelines may need updating to reflect the safety of laparoscopic approaches for larger adrenal tumors.