[Clinical study of 25 cases with adrenal tumor--comparison between transabdominal, translumbar, laparoscopic...

Adrenalectomy for adrenal tumor was performed on 25 patients at Kushiro municipal general hospital between 1982 and 1993. There were 17 women and 8 men aged 34 to 66 (mean 52.7) years. Clinical diagnoses were pheochromocytoma (6), Cushing's syndrome (8), primary aldosteronism (4), incidentaloma (7). Pathological diagnoses were pheochromocytoma (6), cortical adenoma (17), hyperplasia with hypercortisolism (1), schwannoma (1). Angiography and venous sampling were unuseful for clinical identification of adrenal tumor. After removal of the tumor, glucose-intolerance disappeared in 4 of 6 cases with pheochromocytoma and one of 7 cases with incidentaloma, mental aberration was improved in 2 of 8 cases with Cushing's syndrome, and hypertension was improved in 4 of 7 cases with incidentaloma. Since clinical symptoms (hypertension and glucose-intolerance) were improved postoperatively in 4 of 7 cases with incidentaloma, adrenalectomy is recommended for incidentaloma. Transabdominal approach was suitable for pheochromocytoma and bilateral adrenal tumor, but postoperative recovery was slow. In our experience, pleural injury was found in 40% of translumbar approach. Four laparoscopic operations were performed recently, this procedure gave most fast postoperative recovery to compare with other approach.