Laparoscopic trans- and retroperitoneal adrenal surgery for large tumors
Background: Laparoscopic adrenalectomy for tumors larger than 6 cm is currently a matter of controversial discussion because of difficult mobilization from surrounding organs and a possible risk of capsule rupture. Materials and Methods: Data of consecutive patients undergoing laparoscopic adrenalec...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2014-01-01
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| Series: | Journal of Minimal Access Surgery |
| Subjects: | |
| Online Access: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2014;volume=10;issue=2;spage=57;epage=61;aulast=Agha |
| _version_ | 1819173717750579200 |
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| author | Ayman Agha Igors Iesalnieks Matthias Hornung Wiggermann Phillip Andreas Schreyer Michael Jung Hans J Schlitt |
| author_facet | Ayman Agha Igors Iesalnieks Matthias Hornung Wiggermann Phillip Andreas Schreyer Michael Jung Hans J Schlitt |
| author_sort | Ayman Agha |
| collection | DOAJ |
| description | Background: Laparoscopic adrenalectomy for tumors larger than 6 cm is currently a matter of controversial discussion because of difficult mobilization from surrounding organs and a possible risk of capsule rupture. Materials and Methods: Data of consecutive patients undergoing laparoscopic adrenalectomy between 1/1994 and 7/2012 were collected and analysed retrospectively. Intra- and postoperative morbidity in patients with tumors ≤6 cm (group 1, n = 227) were compared to patients with tumors >6 cm, (group 2, n = 52). Results: Incidence of adrenocortical carcinoma was significantly higher in group 2 patients (6.3% vs. 0.4%, P = 0.039) whereas the incidence of aldosterone-producing adenoma was lower (2% vs. 25%, P = 0.001). Mean duration of surgery was longer (105 min vs. 88 min, P = 0.03) and the estimated blood loss was higher (470 mL vs. 150 mL) in group 2 patients. Intraoperative bleeding rate (5.7% vs. 0.8%, P = 0.041), and the conversion rate were significantly higher (5.7% vs. 1.3%, P = 0.011) in group 2. Also, postoperative complication rate was significantly higher in group 2 (11.5% vs. 3.0%, P = 0.022). However, only two major complications occurred, one in each group. Conclusion: Minimally invasive adrenal surgery can be performed by an experienced surgeon even in patients with large tumors (>6 cm) with an increased but still acceptable intra- and postoperative morbidity. |
| first_indexed | 2024-12-22T20:27:31Z |
| format | Article |
| id | doaj.art-27b8cb8701e641aaa9c56a4384f467a4 |
| institution | Directory Open Access Journal |
| issn | 0972-9941 1998-3921 |
| language | English |
| last_indexed | 2024-12-22T20:27:31Z |
| publishDate | 2014-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj.art-27b8cb8701e641aaa9c56a4384f467a42022-12-21T18:13:41ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212014-01-01102576110.4103/0972-9941.129943Laparoscopic trans- and retroperitoneal adrenal surgery for large tumorsAyman AghaIgors IesalnieksMatthias HornungWiggermann PhillipAndreas SchreyerMichael JungHans J SchlittBackground: Laparoscopic adrenalectomy for tumors larger than 6 cm is currently a matter of controversial discussion because of difficult mobilization from surrounding organs and a possible risk of capsule rupture. Materials and Methods: Data of consecutive patients undergoing laparoscopic adrenalectomy between 1/1994 and 7/2012 were collected and analysed retrospectively. Intra- and postoperative morbidity in patients with tumors ≤6 cm (group 1, n = 227) were compared to patients with tumors >6 cm, (group 2, n = 52). Results: Incidence of adrenocortical carcinoma was significantly higher in group 2 patients (6.3% vs. 0.4%, P = 0.039) whereas the incidence of aldosterone-producing adenoma was lower (2% vs. 25%, P = 0.001). Mean duration of surgery was longer (105 min vs. 88 min, P = 0.03) and the estimated blood loss was higher (470 mL vs. 150 mL) in group 2 patients. Intraoperative bleeding rate (5.7% vs. 0.8%, P = 0.041), and the conversion rate were significantly higher (5.7% vs. 1.3%, P = 0.011) in group 2. Also, postoperative complication rate was significantly higher in group 2 (11.5% vs. 3.0%, P = 0.022). However, only two major complications occurred, one in each group. Conclusion: Minimally invasive adrenal surgery can be performed by an experienced surgeon even in patients with large tumors (>6 cm) with an increased but still acceptable intra- and postoperative morbidity.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2014;volume=10;issue=2;spage=57;epage=61;aulast=AghaAdrenocortical carcinomalaparoscopic adrenalectomypostoperative complications |
| spellingShingle | Ayman Agha Igors Iesalnieks Matthias Hornung Wiggermann Phillip Andreas Schreyer Michael Jung Hans J Schlitt Laparoscopic trans- and retroperitoneal adrenal surgery for large tumors Journal of Minimal Access Surgery Adrenocortical carcinoma laparoscopic adrenalectomy postoperative complications |
| title | Laparoscopic trans- and retroperitoneal adrenal surgery for large tumors |
| title_full | Laparoscopic trans- and retroperitoneal adrenal surgery for large tumors |
| title_fullStr | Laparoscopic trans- and retroperitoneal adrenal surgery for large tumors |
| title_full_unstemmed | Laparoscopic trans- and retroperitoneal adrenal surgery for large tumors |
| title_short | Laparoscopic trans- and retroperitoneal adrenal surgery for large tumors |
| title_sort | laparoscopic trans and retroperitoneal adrenal surgery for large tumors |
| topic | Adrenocortical carcinoma laparoscopic adrenalectomy postoperative complications |
| url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2014;volume=10;issue=2;spage=57;epage=61;aulast=Agha |
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