Experience with laparoscopic adrenalectomy in pediatric patients.
BACKGROUND
Laparoscopic adrenalectomy (LA) is now being recognized as the standard in the management of benign adrenal pathology in adult patients. Few reports have described the use of this technique in pediatric patients. This study combines experience from 2 institutions with lateral transperitoneal LA in children to analyze our results and the clinical and biochemical response to laparoscopic adrenalectomy in patients with hormonally active adrenal tumors.


METHODS
A bi-institutional retrospective review of all patients undergoing LA between January 1997 and January 2001 was performed. Clinical and biochemical data were obtained during routine follow-up.


RESULTS
Seventeen laparoscopic adrenalectomies were performed during this period. The average operating time was 120 minutes, mean estimated blood loss was 25 mL, the mean size of the adrenal lesion was 4.8 cm, and the mean length of hospitalization was 35 hours. Resolution of clinical and biochemical parameters of adrenal hyperfunction was accomplished in all patients with adrenocortical hyperplasia and pheochromocytoma in postoperative follow-up.


CONCLUSIONS
Laparoscopic adrenalectomy can be performed safely and effectively with a short hospital stay, minimal blood loss, and excellent functional outcome in this age group. The authors believe laparoscopic adrenalectomy is an excellent approach for the management of benign pediatric adrenal pathology.
Miller
K A
KA
Children's Mercy Hospital, University of Missouri at Kansas City School of Medicine, Kansas City, MO 64108, USA.
Albanese
C
C
Harrison
M
M
Farmer
D
D
Ostlie
D J
DJ
Gittes
G
G
Holcomb
G W
GW
D000236:Adenoma / Q000601:surgery; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D018268:Adrenocortical Carcinoma / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003480:Cushing Syndrome / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005729:Ganglioneuroma / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D010673:Pheochromocytoma / Q000601:surgery; D012189:Retrospective Studies