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KMID : 0978820080110010030
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2008 Volume.11 No. 1 p.30 ~ p.34
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Clinical Significance of Laparoscopic Adrenalectomy
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Kim Tae-Won
Lee Jae-Im
Kim Do-Hyoung
Cho Hang-Joo
Choi Jae-Young
Kim Eung-Kook
Lee Sang-Kuon
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Abstract
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Purpose: Ever since the introduction of laparoscopic adrenalectomy for benign adrenal tumors by Gagner et al.
in 1992, technical advancements have allowed for its use in large benign adrenal tumors, pheochromocytomas, and
primary and metastatic adrenal carcinomas. The purpose of this study was to analyze the surgical outcomes associated
with laparoscopic adrenalectomies performed in our institution.
Methods: We performed a retrospective analysis of 37 patients who underwent laparoscopic adrenalectomies at St. Mary’s Hospital, the Catholic University of Korea, between January 2000 and July 2007. Among these patients, 23 were
women and 14 were men.
Results: Right adrenalectomy was performed in 20 patients, left in 16, and bilateral in 1. The average operative time was 247 minutes, with an average blood loss of 331 cc. The average postoperative hospitalization period was 7.2 days. Adrenocortical adenomas were most common (16 cases), followed by adrenocortical hyperplasia (5 cases). One patient with a pheochromocytoma underwent a concurrent thyroidectomy for multiple endocrine neoplasia (MEN) 2A. Four cases of adrenal malignancy were included in this series. The average follow-up period was 17.2 months (range 1 to 71 months). In the malignant cases, there was no recurrence.
Conclusion: Laparoscopic adrenalectomy seems to be an effective treatment for various adrenal diseases. It offers the advantages of shorter hospitalization, lower risk of wound infection, and early recovery. Furthermore, it may be cautiously indicated for select cases of well-localized, node-negative adrenal malignancies, such as carcinomas and metastatic tumors. Laparoscopic adrenalectomy does not appear to be a contraindicated in patients who have undergone prior open abdominal surgery.
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KEYWORD
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Adrenalectomy, Laparoscopic surgery, Adrenal
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