30. Outcomes of retroperitoneal laparoscopic adrenalectomy for treatment of endocrine active adrenal tumors

Tran Quoc Hoa, Nguyen Dinh Bac

Main Article Content

Abstract

The purpose of this study is to evaluate the effectiveness and safety of retroperitoneal laparoscopic adrenalectomy (RLA) to treat endocrine active adrenal tumors. From July 2021 to July 2023, 38 patients underwent RLA and no patient underwent conversion . The mean age in the study was 44.8 ± 12.7 years old, mean BMI was 22.0 ± 2.7, and mean tumor size was 25.8 ± 13.5mm. The mean operation time was 76.3 ± 15.0 minutes. No patient required blood transfusion during or after surgery. There were two patients with post-operative complications, including one patient with Conn’s syndrome developed fever and one patient with Cushing’s syndrome had residual fluid. The mean hospital stay was 3.8 ± 1.4 days. The average follow-up period was 12.4 ± 7.4 months. There were 5 patients accounted for 13.2% with postoperative adrenal insufficiency and 84.2% of patients with good result. Thus, RLA is a safe and effective procedure to treat endocrine active adrenal tumors.

Article Details

References

1. Ciftci AO, Senocak ME, Tanyel FC, et al. Adrenocortical tumors in children. J Pediatr Surg. 2001; 36:549–554.
2. Mantero F, Terzolo M, Amaldi G, et al. Study group on Adrenal Tumors of the Italian Society of Endocrinology. A survey on adrenal incidentaloma in Italy. J Clin Endocrinol Metab. 2000; 85:637644.
3. Terzolo M, Stigliano A, Chiodini I, et al. AME position statement on adrenal incidentaloma. Eur J Endocrinol. 2001; 163:851–870.
4. Kloos RT, Gross MD, Francis IR, et al. Incidentally discovered adrenal masses. Endocr Rev. 1995; 16:460–484.
5. Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2016; 175:G1–G34.
6. Giovanni Alemanno, Carl Bergamini, Paolo Prosperi, et al. Adrenalectomy: indications and options for treatment. Updates in Surgery. 2017; 69(2):119–125.
7. Gagner M, Lacroix A, Prinz RA, et al. Early experience with laparoscopic approach for adrenalectomy. Surgery. 1993; 114(6):1120–1124
8. Corssmit Eleonora P.M., Dekkers Olaf M. Screening in adrenal tumors. Current Opinion in Oncology. 2019; 31(3):243–246.
9. Talal Al-Jalabneh, Omar Al-Shawabkeh, Ibrahim Al-Gwairy, et al. Laparoscopic Versus Open Adrenalectomy: a Retrospective Comparative Study. Med Arch. 2021; 75(1): 41-44
10. Nigri G., Rosman A. S., Petrucciani N., et al. Meta-analysis of trials comparing laparoscopic transperitoneal and retroperitoneal adrenalectomy. Surgery. 2013; 153(1): 111–119.
11. Zhao Liu , Dawei Li, Lei Yan, et al. Comparison of lateral transperitoneal and retroperitoneal approaches for homolateral laparoscopic adrenalectomy. BMC Surgery. 2021; 21:432.
12. L. Michael Brunt, Jeffrey F. Moley, Gerard M. Doherty, et al. Outcomes analysis in patients undergoing laparoscopic adrenalectomy for hormonally active adrenal tumors. Surgery. 2001; 130(4): 629-635.
13. Wierdak Mateusz, Sokołowski Grzegorz, Natkaniec Michał, et al. Short- and long-term results of laparoscopic adrenalectomy for Conn’s syndrome. Videosurgery and Other Miniinvasive Techniques. 2018; 13(3): 292–298.
14. Giovanni Conzo, Daniela Pasquali, Claudio Gambardella, et al. Long-term outcomes of laparoscopic adrenalectomy for Cushing disease. International Journal of Surgery. 2014; 12: S107–S111.
15. Takanobu Utsumi, Shota Iijima, Yuka Sugizaki, et al. Laparoscopic adrenalectomy for adrenal tumors with endocrine activity: Perioperative management pathways for reduced complications and improved outcomes. International Journal of Urology. 2023. doi: 10.1111/iju.15218.