Laparoscopic adrenalectomy in children.
BACKGROUND
The aim of this study was to describe the indications and results of laparoscopic adrenalectomy in children.


METHODS
This retrospective multicenter study included six children (four boys, two girls) aged 2-16 years (mean, 9.5). Three children had hypertension. In three cases, the adrenal mass was discovered incidentally. The tumors were bilateral in two children, right-sided in two cases, and left-sided in two cases. The mean tumor size was 4 cm (range, 1-7). Each child underwent MIBG scintigraphy and MRI before the operation.


RESULTS
Four right and two left adrenal glands were resected by laparoscopy (transperitoneal), and two left glands were resected by retroperitoneoscopy. Two conversions were necessary for two left adrenal glands (one retroperitoneoscopy, one laparoscopy). Two partial resections and six adrenalectomies were performed. Histological examination of the tumors revealed two ganglioneuromas, one neuroblastoma, and five pheochromocytomas (two bilateral). One child had an involved node (pheochromocytoma). Both bilateral pheochromocytomas had von Hippel-Lindau disease. There was no morbidity. Mean hospitalstay was 6 days. Postoperative evaluation at 1 month was normal in all children.


CONCLUSIONS
The indications for laparoscopic adrenalectomy in children are benign tumors and pheochromocytomas. In these cases, laparoscopic adrenalectomy is feasible and safe, even in cases of pheochromocytoma.
Mirallié
E
E
Department of Pediatric Surgery, Hotel Dieu, Centre Hospitalier Universitaire, Nantes 44093, France.
Leclair
M D
MD
de Lagausie
P
P
Weil
D
D
Plattner
V
V
Duverne
C
C
DeWint
A
A
Podevin
G
G
Héloury
Y
Y
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D010673:Pheochromocytoma / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome