[Laparoscopic adrenalectomy].
OBJECTIVE
Laparoscopic adrenalectomy is a standard procedure in adult patients. In the pediatric patient the same advantages with regard to traditional surgery have been demonstrated in the treatment of localized adrenal tumours. The aim of this work is to analyze our initial experience in this technique.


METHODS
We have reviewed our last three adrenalectomy cases. They were two girl and a boy aged 4, 15 and 17 year-old. The etiology was pheochromocytoma in two cases and one ganglioneuroblastoma. In two cases the tumour was right-sided and the other one was in the left adrenal gland. All cases were studied with ultrasound, TC and MRI. Patients with pheochromocytoma were also studied with MIBG-scintigraphy and genetics, hormone and endocrine MEN screening. One patient with pheochromocytoma had von Hippel-Lindau disease. Main size tumour was 40 mm. Preoperative alpha-blockade in pheochromocytoma was done with prazosín and intraoperative with nitroprusside. In lateral decubitus position, through four 10 and 5 mm ports, in two cases adrenalectomy was performed and tumorectomy in one.


RESULTS
Main operating time was 120 minutes. There was no operative-related complication. Blood pressure in pheochromocytoma patients was controlled without drugs 36h after surgery. They were discharged between the 2nd and 4th postoperative day. No incidences on follow-up.


CONCLUSIONS
Adrenalectomy joins other pediatric procedures affordable with the laparoscopic approach. It minimizes surgical trauma, gland exposure is better, allows a safe and quick resection in adrenal tumours, with a short and suitable postoperative course.
Servicio de Cirugía Pediátrica, Unidad Integrada, Hospital Sant Joan de Déu/Hospital Clinic, Barcelona, Universidad de Barcelona. anabosque@hsjdbcn.es
X
X
Tarrado
J M
JM
Ribó
L
L
Morales
D000293:Adolescent; D000315:Adrenalectomy / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male