[Laparoscopic adrenalectomy in multiple endocrine tumors, in secreting and non-secreting lesions].
OBJECTIVE
Personal experience in laparoscopic adrenalectomies (LA) for secreting and non-secreting tumors is presented.


METHODS
Between March 1995 and December 2001 a total of 111 LA (58 left, 49 right and 4 bilateral) were performed in 60 females and 51 males, mean age 47.5 (range 8-81) years, for: 38 Conn diseases, 24 incidentalomas, 15 pheochromocytomas, 13 Cushing diseases, 4 kysts, 3 angiomyolipomas, 1 adreno-genital syndrome, 1 hydatidosis, 1 hyperplasia, 1 ganglioneuroma, 1 oncocyte adenoma, 1 adrenal fibrous tumor, 4 cortical carcinomas and 4 metastases (from renal carcinoma, breast carcinoma, leiomyosarcoma and rabdoid sarcoma, respectively). In all cases LA was transabdominal with a lateral flank approach.


RESULTS
Mean global operative time was 88.6 minutes (range 35-240). Conversion rate was 1.8% (2/111). There was low postoperative pain. Mean hospital stay was 4.3 days (range 2-13). There were 0.9% (1/111) 30-day mortality and 4.5% (5/111) morbidity. During a mean follow-up of 41 months (range 1-81), the 67 secreting patients were disease-free. Concerning 8 malignant cases, mean follow-up was 40.5 months (range 9-72) with 3 cortical carcinomas disease-free and 1 dead for stroke, 2 metastases (1 leiomyosarcoma and 1 breast carcinoma) dead for disease and 2 disease-free. There was no port-site metastases.


CONCLUSIONS
LA seems safe and effective when performed in experienced Centers on endocrine surgery and laparoscopy.
Giraudo
G
G
Chirurgia Generale II, Dipartimento di Discipline Medico-Chirurgiche Università degli Studi di Torino, Torino, Italy.
Del Genio
G
G
Porpiglia
F
F
Parini
D
D
Garrone
C
C
Morino
M
M
D000293:Adolescent; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009377:Multiple Endocrine Neoplasia / Q000378:metabolism* / Q000601:surgery*