Retroperitoneal endoscopic adrenalectomy is safe and effective

Background: The aim of this study was to review an experience with retroperitoneal endoscopic adrenalectomy (REA). This is the procedure of choice for adrenal tumours at this institution. Methods: Between 1997 and 2008, 112 REAs were performed in a single university centre. Data were retrieved retro...

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Bibliographic Details
Published in:British journal of surgery 2010-11, Vol.97 (11), p.1667-1672
Main Authors: Schreinemakers, J. M. J., Kiela, G. J., Valk, G. D., Vriens, M. R., Rinkes, I. H. M. Borel
Format: Article
Language:English
Subjects:
Adolescent
Adrenal Gland Neoplasms - surgery
Adrenalectomy - adverse effects
Adrenalectomy - methods
Adrenocortical Adenoma - surgery
Adult
Aged
Biological and medical sciences
Child
Endoscopy - methods
Epidemiologic Methods
General aspects
Humans
Medical sciences
Middle Aged
Pheochromocytoma - surgery
Pituitary ACTH Hypersecretion - surgery
Postoperative Complications - prevention & control
Retroperitoneal Space
Treatment Outcome
Young Adult
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Summary:Background: The aim of this study was to review an experience with retroperitoneal endoscopic adrenalectomy (REA). This is the procedure of choice for adrenal tumours at this institution. Methods: Between 1997 and 2008, 112 REAs were performed in a single university centre. Data were retrieved retrospectively from a prospectively collected database, including information on patient demographics, surgical procedure, complications and hospital stay. Results: One hundred and twelve REAs were carried out successfully in 105 patients, including seven bilateral adrenalectomies. Thirty‐nine patients with unilateral adrenal disease had a phaeochromocytoma, of whom 16 had multiple endocrine neoplasia syndrome type 2, 21 patients had Cushing's disease and 20 had Conn's disease. Median body mass index was 27 (interquartile range 23–29) kg/m2. The median duration of unilateral operations was 100 (90–130) min with a median blood loss of 5 ml. Median tumour size was 3·1 (2·0–4·4) cm. Conversion from REA to open surgery was needed in two patients. Seven patients experienced postoperative complications (2 major, 5 minor). One patient needed a reoperation. The median postoperative hospital stay was 3 days. A learning curve with a significant decrease in operating time was observed over the years. Conclusion: REA appears to be a safe and effective surgical technique for adrenal gland tumours up to 6 cm in diameter, with a minimal complication rate. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Excellent results achieved
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.7191