title: Adrenal-preserving laparoscopic surgery in selected patients with bilateral adrenal tumors.
abstract: BACKGROUND
  There have been few reports of laparoscopic adrenal-sparing surgery for bilateral adrenal tumors. We review our experience with this type of surgery with the aim of evaluating its feasibility and safety.
  
  
  METHODS
  Over a 4-year period, we treated 9 patients with bilateral benign adrenal tumors. Seven patients had bilateral pheochromocytomas (MEN 2: 5, VHL: 1, sporadic: 1), and 2 patients had Cushing's syndrome caused by bilateral adrenocortical adenomas. Laparoscopic procedures were performed by a flank approach. The mean diameter of the tumors was 3.7 cm (range, 2.0-8.5 cm).
  
  
  RESULTS
  All the tumors were removed laparoscopically. Four patients with hereditary pheochromocytomas underwent bilateral total adrenalectomy because of the large tumor size and multiplicity. The other 5 patients were treated successfully with preservation of adrenocortical function. In 4 of these 5 patients, the adrenal tumors were 3 cm or less in diameter. None of the patients experienced surgical complications. At a mean follow-up of 16 months (range, 4-40 months), none of the 5 patients who were treated by adrenal-sparing surgery required corticosteroid replacement.
  
  
  CONCLUSIONS
  Laparoscopic surgery is feasible for the treatment of bilateral adrenal tumors. Adrenal-preserving laparoscopic surgery may be practicable for the removal of these tumors, if the tumor on either side is 3 cm or less in diameter; however, our follow up is short (mean, 16 months).
authors.affiliation: Department of Endocrine Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Iihara
authors.forename: Rumi
authors.initials: R
authors.lastname: Suzuki
authors.forename: Akiko
authors.initials: A
authors.lastname: Kawamata
authors.forename: Yoko
authors.initials: Y
authors.lastname: Omi
authors.forename: Hitomi
authors.initials: H
authors.lastname: Kodama
authors.forename: Yuka
authors.initials: Y
authors.lastname: Igari
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Takao
authors.initials: T
authors.lastname: Obara
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D018246:Adrenocortical Adenoma / Q000601:surgery*; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome