Journal Article

Laparoscopic adrenalectomy for large tumours: Single team experience

Deshpande, AparnaA, Thapar, PinkyM, Dalvi, AbhayN, Thapar, VinaykumarB, Rege, SameerA

2012

Overview

Laparoscopic adrenalectomy (LA) has become the procedure of choice to treat benign functioning and non-functioning adrenal tumours. With improving experience, large adrenal tumours (> 5 cm) are being successfully tackled by laparoscopy. This study aims to present our single unit experience of LA performed for large adrenal masses. Forty-six laparoscopic adrenalectomies performed for large adrenal lesions more than 5 cm during the period 2001 to 2010 were reviewed. A total of 46 adrenalectomies were done in 42 patients. The mean tumour size was 7.03 cm (5-15 cm). Fourteen patients had tumour size more than 8 cm. The lesions were localised on the right side in 17 patients and on the left side in 21 patients with bilateral tumours in 4 patients. Functioning tumours were present in 32 of the 46 patients. The average blood loss was 112 ml (range 20-400 ml) with the mean operating time being 144 min (range 45 to 270 min). Five patients required conversion to open procedure. Three of the 46 patients (6.52%) on final histology had malignant tumours. LA is safe and feasible for large adrenal lesions. Mere size should not be considered as a contraindication to laparoscopic approach in large adrenal masses. Graded approach, good preoperative assessment, team work and adherence to anatomical and surgical principles are the key to success.

• Publisher: Medknow Publications and Media Pvt. Ltd,Medknow Publications & Media Pvt. Ltd,Medknow Publications & Media Pvt Ltd,Wolters Kluwer Medknow Publications
• Subject: Adrenalectomy / Gastrointestinal surgery / Laparoscopic surgery / Laparoscopy / large tumours / Methods / Original / Surgical techniques / Tumors