Endoskopie, 2010; 19(3-4): 101-104

Is laparoscopic adrenalectomy the gold standard ?

prof.MUDr.Mojmír Kasalický, CSc.¹, MUDr.Radek Pohnán¹, MUDr.Radek Doležel¹, doc.MUDr.Tomáš Zelinka, CSc.²

¹ Chirurgická klinika 2. LF UK a ÚVN v Praze

² 3. interní klinika 1. LF UK a VFN v Praze

Background: Presently the laparoscopic adrenalectomy (LA) becomes most popular since 1992 when it was performed for the first time

by laparoscopic method by Gagner. Typical indication for LA is the aldosteron-secreting adenoma, Cushing’s syndrome, feochromocytoma

or rare tumors such as adrenal cyst or myelolipomas.

Methods: LA is provided with transperitoneal lateral approach most frequently then in back side position. Retroperitoneal approach

is used less commonly. Since 2006, firstly at the 1st Surgical department of 1st Medical School of Charles University and General Faculty

Hospital and lastly at the Surgical department 2nd Medical School of Charles University and Central Military Hospital, has been performed

on the whole 137 LA in 130 patients. The bilateral LA was performed in 7 patients. The conversion from the laparoscopic to open

adrenalectomy was necessary by reason of the king size of the tumor (13/14 cm) in two cases. The lateral position and transperitoneal

approach was used in all cases.

Results: Average length of the operation was 82 minutes (40–154 min), respective 185 minutes (125–270 min) in the case of the bilateral

LA. The median size of the adrenal tumor was 4,9 cm (1,8–12,5 cm) with average weight 44 g (18–421 g). All of the patients after LA were

monitored for 24 hours in the Intensive care units. The average time of the hospitalization was 3,7 days (2–6 days).

Conclusion: Laparoscopic adrenalectomy presently is considered as the“ gold standard” procedure for adrenal tumors to the size 10 cm,

irrespective of the tumor is benign or malignant.

Keywords: laparoscopic adrenalectomy, transabdominal approach, adrenal tumors

Published: November 24, 2010  Show citation