Laparoscopic adrenalectomy for isolated adrenal metastasis.
BACKGROUND
Laparoscopic adrenalectomy is accepted by many as the standard of care for the majority of adrenal masses less than 8 cm. The question exists whether laparoscopic removal of metastatic lesions to the adrenal is more difficult than laparoscopic removal of primary adrenal lesions.


METHODS
We performed a retrospective analysis of all laparoscopic adrenalectomies performed at a single institution from 1998 to 2001, comparing laparoscopic adrenalectomies for primary lesions of the adrenal gland versus isolated metastatic lesions to the adrenal gland.


RESULTS
Fourteen laparoscopic adrenalectomies were attempted, 10 for primary disease and 4 for metastatic disease. All 10 laparoscopic procedures were completed successfully for primary disease (average operative time=218 minutes, average tumor size=4 cm, median hospital stay=2 days). Only one of the 4 laparoscopic adrenalectomies for metastatic disease was completed successfully (average operative time=332 minutes, average tumor size=7.3 cm, median hospital stay=2 days). No major complications occurred in either group.


CONCLUSIONS
We feel laparoscopic adrenalectomy is the preferred approach for primary adrenal masses less than 8 cm. Based on our experience and a review of the literature, isolated metastatic lesions to the adrenal gland appear less amenable to laparoscopic removal than do primary lesions of the same size.
Gerber
Eric
E
Department of Urology, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, New York, USA.
Dinlenc
Caner
C
Wagner
Joseph R
JR
D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008175:Lung Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome