Laparoscopic Transperitoneal Approach to Adrenal Gland Malignancies

• Authors: Kazimierz Rembiasz , Andrzej Budzyński , Jan Kulawik , Maciej Matłok , Marcin Migaczewski , Alicja Hubalewska-Dydejczyk , Filip Gołkowski
• Languages of publication: EN

Abstracts

EN

Even though there is not enough good data, the use of laparoscopic approach in malignant disease is regarded by some controversial issue. On the other hand it seems that transperitoneal access to the adrenal gland allows for effective and safe oncological removal of adrenal gland neoplasms.The aim of the study was to present our experience with the use of transperitoneal approach in patients with adrenal gland malignancies.Material and methods. From March 2003 till May 2009 we performed 200 laparoscopic transperitoneal adrenalectomies. There were 82 hormonally silent tumors (1.5-14 cm in diameter) and 118 hormonally active (63 pheochromocytomas, 26 Conn's syndrome, 25 Cushing's syndrome and 4 virylizing tumors).Results. 197 procedures were completed laparoscopically and 3 were converted (including one for inability to assess resectablility of the tumor). 14 tumors (7%) were overtly malignant; 7 arising form the adrenal (adrenal cortex - 3, pheochromocytoma - 3, lymphoma - 1) and 7 metastatic (squamous cell cancer of the lungs - 2, clear cell carcinoma of the kidney - 2, collecting duct carcinoma of the kindey - 1, hepatocellular cancer - 1, NET lung tumor - 1). Further 19 tumors (9.5%) were assessed histologically as potentially malignant (pheochromocytomas - 16, tumors of neural origin - 2, oncocytomas - 1). One malignant tumor was unresectable other were operated radically. Progression of the cancer was observed in 3 patients with metastatic tumors.Conclusions. Laparoscopic transperitoneal adrenalectomy allows for safe and radical removal of adrenal gland malignancies. Longer follow-up and larger patients volume are needed for better evaluation of long-term results.

Keywords

EN

adrenal tumors; laparoscopic adrenalectomy; transperitoneal approach

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2009
• Volume: 81
• Issue: 12
• Pages: 609-618

Dates

published

1 - 12 - 2009

online

25 - 1 - 2010

Contributors

author

Kazimierz Rembiasz

• 2 Department of General Surgery, Collegium Medicum Jagiellonian University, Cracow

author

Andrzej Budzyński

• 2 Department of General Surgery, Collegium Medicum Jagiellonian University, Cracow

author

Jan Kulawik

• 2 Department of General Surgery, Collegium Medicum Jagiellonian University, Cracow

author

Maciej Matłok

• 2 Department of General Surgery, Collegium Medicum Jagiellonian University, Cracow

author

Marcin Migaczewski

• 2 Department of General Surgery, Collegium Medicum Jagiellonian University, Cracow

author

Alicja Hubalewska-Dydejczyk

• Department of Endocrinology, Collegium Medicum Jagiellonian University, Cracow

author

Filip Gołkowski

• Department of Endocrinology, Collegium Medicum Jagiellonian University, Cracow

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Identifiers

DOI

10.2478/v10035-009-0098-6