[Limits of laparoscopic surgery of adrenal glands. Apropos of 17 cases and a review of the literature].
OBJECTIVE
To review own cases of laparoscopic adrenalectomy in order to better ascertain limits therapeutic management and indications, compared with the literature data.


METHODS
Medical files of 15 patients after 17 laparoscopic adrenalectomies in the Dupuytren hospital of Limoges from February 1994 to November 1996, were analyzed 10 women and 5 men mean aged 59.4 years (22-77) were operated. Transperitoneal laparoscopic adrenal resection indications were: Conn adenoma (3), Cushing discase (2 bilateral resection), adrenal incidentaloma (9) and adrenal metastasis (1).


RESULTS
Mean (range) of adrenal tumor size was 4 cm (0.8-7.5 cm). Operating times mean (range) was: 3 hours 40 minutes (1 h 50-6 h). Mean (range) of hospital stay was 3.4 day (3-6), marquedly reduced than open traditional adrenal surgery. Neither complication nor mortality per- or post-operative were present. But the laparoscopic operation required conversion to an open adrenal resection in 3 cases (18%).


CONCLUSIONS
Laparoscopic adrenalectomy offer real advantages: effectiveness and safety with a reduced time hospital discharge. Indications and adrenal size limits need to be precised on largest studies.
Service de Médecine Interne B, Endocrinologie et Maladies Métaboliques, CHU-Hôpital du Cluzeau, rue Dominique Larrey, Limoges.
M P
MP
Teissier
B
B
Descottes
D
D
Valleix
A
A
Gainant
F
F
Archambeaud
L
L
Navarre
M
M
Quam Sodji
D000307:Adrenal Gland Diseases / Q000175:diagnosis / Q000601:surgery*; D000315:Adrenalectomy / Q000191:economics / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome