LAPAROSCOPIC ADRENALECTOMY: SINGLE CENTRE EXPERIENCE.

Abstract

Objective: Laparoscopic adrenalectomy is today considered the gold standard treatment for all benign adrenal tumors. The aim of this study is to evaluate the results of laparoscopic adrenalectomy in a single centre. Methods: We reviewed clinical data on 32 adrenalectomies performed at our istitution from 2009 to 2012. The average age of patients was 47 years (range 38-68); 18 were men and 14 women. For the clinical analysis, patients were divided into the nonfunctioning tumor group (n = 20) and the functioning tumor group (n = 12). All operations were performed via transperitoneal lateral access. Results: All laparoscopic adrenalectomy were finished successfully and no open surgery was necessary. The median operative time and blood loss in two group were similar. Only in a case of non-functioning left adrenal mass we had a significative intraoperative blood loss managed via laparoscopy with hemostatic matrix. 3 patients with aldosteronoma became normotensive and no longer required postoperative blood pressure medications. 9 patients with Cushing adenoma had resolution or improvement of clinical signs during follow-up periods. In a case at definitive histological analysis we found an adrenocortical carcinoma treated with no capsular disruption during dissection. Conclusions: The results of this retrospective review document that laparoscopic adrenalectomy is a safe and effective treatment for functioning as well as and non-functioning adrenal tumors. Pre-operative workup plays a fundamental role in these diseases. Mere size should not be considered as a contraindication to laparoscopic approach in adrenal masses without signs of local invasion.