Over 10 Years of Experience in the Laparoscopic Treatment of Adrenal Lesions via Lateral Transperitoneal Approach

• Authors: Maciej Otto , Jacek Dzwonkowski , Tomasz Ciąćka , Maciej Jędrasik
• Languages of publication: EN

Abstracts

EN

The aim of the study was to present own experience in the treatment of adrenal pathology using laparoscopic adrenalectomy (LA) via lateral transperitoneal approach.Material and methods. From 29.10.1997 to 30.04.2008 in the Department of General, Vascular and Transplant Surgery of Warsaw Medical University 417 LA have been performed in 405 patients. The indications were 195 (48%) non-functioning incidentaloma type tumors and 210 (52%) functioning tumors. Among them hypercortisolism in 66 (31.5%) patients (Cushing's disease - 3, Cushing's syndrome -28, subclinical Cushing's syndrome - 35), pheochromocytoma in 82 (39%), Conn's syndrome in 61 (29%) and adrenogenital syndrome in 1 (0.5%). There where 288 (71%) women and 117 (29%) men with the mean age of 51.8 years. The mean size of adrenal tumor was 41.1 mm. In 62 (15%) bilateral lesions were noted. All patients were operated laparoscopically via lateral transabdominal approach.Results. LA was successful in 393 patients (97%). We performed 393 (97%) unilateral LA, 10 (2.5%) bilateral simultaneous LA, 2 (0.5%) bilateral two-staged LA and also 2 (0.5%) sparing LA. 12 (3%) patients underwent simultaneous LA with laparoscopic cholecystectomy due to symptomatic cholecystolithiasis and 2 (0,5%) with laparoscopic umbilical hernioplasty. 12 (3%) conversions were necessary. 15 (3.7%) complications occurred, 3 (0.7%) intraoperative and 12 (3%) postoperative. There was 1 remote death on the 56th postoperative day.Conclusions. 1. LA should be recognize as the referential method in the treatment of adrenal pathology. 2. Results, as well as avoiding unnecessary complications and intraoperative difficulties is possible thanks to: close cooperation with the endocrinologist, experience gained from performing other laparoscopic operations, experience got at making open adrenalectomies.

Keywords

EN

adrenal tumors; adrenalectomy; laparoscopy; minimally invasive surgery

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2008
• Volume: 80
• Issue: 9
• Pages: 478-486

Dates

published

1 - 9 - 2008

online

25 - 9 - 2008

Contributors

author

Maciej Otto

• Department of General, Vascular and Transplant Surgery, Medical University, Warsaw

author

Jacek Dzwonkowski

• Department of General, Vascular and Transplant Surgery, Medical University, Warsaw

author

Tomasz Ciąćka

• Department of General, Vascular and Transplant Surgery, Medical University, Warsaw

author

Maciej Jędrasik

• Department of General, Vascular and Transplant Surgery, Medical University, Warsaw

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Identifiers

DOI

10.2478/v10035-008-0069-3