Retroperitoneal endoscopic adrenalectomy is safe and effective

Br J Surg. 2010 Nov;97(11):1667-72. doi: 10.1002/bjs.7191.

Abstract

Background: The aim of this study was to review an experience with retroperitoneal endoscopic adrenalectomy (REA). This is the procedure of choice for adrenal tumours at this institution.

Methods: Between 1997 and 2008, 112 REAs were performed in a single university centre. Data were retrieved retrospectively from a prospectively collected database, including information on patient demographics, surgical procedure, complications and hospital stay.

Results: One hundred and twelve REAs were carried out successfully in 105 patients, including seven bilateral adrenalectomies. Thirty-nine patients with unilateral adrenal disease had a phaeochromocytoma, of whom 16 had multiple endocrine neoplasia syndrome type 2, 21 patients had Cushing's disease and 20 had Conn's disease. Median body mass index was 27 (interquartile range 23-29) kg/m(2). The median duration of unilateral operations was 100 (90-130) min with a median blood loss of 5 ml. Median tumour size was 3.1 (2.0-4.4) cm. Conversion from REA to open surgery was needed in two patients. Seven patients experienced postoperative complications (2 major, 5 minor). One patient needed a reoperation. The median postoperative hospital stay was 3 days. A learning curve with a significant decrease in operating time was observed over the years.

Conclusion: REA appears to be a safe and effective surgical technique for adrenal gland tumours up to 6 cm in diameter, with a minimal complication rate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenal Gland Neoplasms / surgery*
  • Adrenalectomy / adverse effects
  • Adrenalectomy / methods*
  • Adrenocortical Adenoma / surgery
  • Adult
  • Aged
  • Child
  • Endoscopy / methods*
  • Epidemiologic Methods
  • Humans
  • Middle Aged
  • Pheochromocytoma / surgery
  • Pituitary ACTH Hypersecretion / surgery
  • Postoperative Complications / prevention & control*
  • Prohibitins
  • Retroperitoneal Space
  • Treatment Outcome
  • Young Adult