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Qualification and Operative Difficulties of Laparoscopic Adrenalectomy

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Otto M., Dzwonkowski J., Jędrasik M., Ciąćka T., Górnicka B., Życińska K., Szmidt J.

Polish Journal of Surgery

2010

vol. 82

issue 1

38-46

Laparoscopic adrenalectomy (LA) became referential in the treatment of adrenal pathology. However in the majority of tumors biochemical markers and imaging examinations aren't reliable to evaluate existences of the malignant process before the operation. Therefore complete resection of the adrenal gland, without damaging the capsule of the tumor remains as a significant problem.The aim of the study was to introduce the problem involving the qualification of the patients for laparoscopic adrenalectomy, and concerning the post-operative histopathologic evaluation, as well as technical aspects of the conducted laparoscopy.Material and methods. These problems are being discussed based on our experience in laparoscopic adrenalectomy. In the period 29.10.1997 - 31.01.2009 472 laparoscopic adrenalectromies were carried out via lateral transperitoneal approach. Among 457 operated patients in 13 (2.8%) conversion was necessary.Results. The malignant lesions were in 22 (4.8%) patients. 11 (2.4%) had metastases from other origin, 1 (0.2%) had Cushing's syndrome and 3 (0.6%) had pheochromocytomas. In the incidentaloma group 6 (13.1%) primary ardenocortical carcinoma and 1 (0.2%) angiosarcoma were identified.Conclusions. Laparoscopic adrenalectomy via lateral transperitoneal approach is a sufficient and safe surgical treatment of adrenal pathology.

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1 Polish Journal of Surgery

1 2010

1 Ciąćka T.

1 Dzwonkowski J.

1 Górnicka B.

1 Jędrasik M.

1 Otto M.

1 Szmidt J.

1 Życińska K.

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Qualification and Operative Difficulties of Laparoscopic Adrenalectomy