[Adrenalectomy by posterior approach for benign adrenocortical tumors. Apropos of 12 cases].
The posterior extra-peritoneal route is usually preferred for exeresis of benign tumors of the adrenal glands measuring less than 5 cm. We examined the hospital reports for patients in which Young access was used since 1985. From December 1985 to December 1994, 12 patients underwent surgery for benign tumor of the adrenal gland. There were 9 women and 3 men (mean age 49.4 years, range 29-67). In all patients, the tumor was localized pre-operatively on a CT-scan. There was a unique tumor in each case. There were 11 adrenal adenomas including 10 Conn tumors and 1 secreting tumor (Cushing's syndrome). The last case was a cortical cyst. One patient died in the post-operative period, probably due to massive pulmonary embolism although necroscopic evidence was not obtained. Parietal infection occurred in one case and a spontaneously regressive hematoma in another. Mean duration of hospitalization was 7.0 days. At follow-up, 1 patient suffered deinnervation of the oblique muscles of the abdomen which did not require reoperation. Two months after surgery, clinical signs and hormone disorders related to the Conn adenomas had regressed in 7 of the 9 patients. In summary, the posterior route is perfectly adapted to the treatment of benign tumors of the adrenal glands when the exact localization can be identified on pre-operative imaging. This access should be considered as the reference route of evaluating laparoscopic procedures.
Brunaud
L
L
Service de Chirurgie C-Chirurgie Digestive et Viscérale, CHU Brabois, Vandoeuvre-les-Nancy.
Bresler
L
L
Tortuyaux
J M
JM
Parent
S
S
Boissel
P
P
D000306:Adrenal Cortex Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000009:adverse effects / Q000379:methods*; D018246:Adrenocortical Adenoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D003480:Cushing Syndrome / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies
Surrénalectomie par voie postérieure pour tumeurs bénignes cortico-surrénaliennes. A propos de 12 cas.