Does tumor size influence the outcome of laparoscopic adrenalectomy?
BACKGROUND
Laparoscopic adrenalectomy is safe and effective for small adrenal tumors, but its role for large adrenal tumors and the influence of tumor size on the outcome of laparoscopic adrenalectomy have been questioned.


METHODS
Thirty-one patients with unilateral adrenal tumors operated on between January 1997 and April 2000 were selected for this study. The indications for surgery were Conn's adenoma in 16 patients, pheochromocytoma in 7 patients, Cushing's adenoma in 4 patients, and incidental lesions in 4 patients. The patients were divided in two groups: 19 patients with tumors <3.5 cm (Group I) and 12 patients with tumors > or = 3.5 cm (Group II). The outcomes of the two groups were compared.


RESULTS
None of the laparoscopic procedures was converted to open surgery. The tumor size correlated with operative time (r = 0.434; P = 0.015) and blood loss (r = 0.513; P = 0.003), with both being significantly greater for larger tumors. No patient required a blood transfusion during or after surgery. One preoperative complication occurred in Group I. There was no peroperative complication in Group II. The median postoperative hospital stay and opioid requirement did not differ significantly between the groups. One patient in Group I developed pneumonia, while no postoperative complications were recorded in Group II.


CONCLUSIONS
Surgery for large adrenal tumors can safely be performed laparoscopically with outcomes comparable to those of surgery for small tumors.
Kazaryan
A M
AM
Interventional Center and the Surgical Department, National Hospital, University of Oslo, Norway. aikazar@hotmail.com
Mala
T
T
Edwin
B
B
D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000601:surgery*; D012196:Review Literature as Topic; D013997:Time Factors; D016896:Treatment Outcome