Laparoscopic management of symptomatic and large adrenal cysts.
OBJECTIVE
We present the feasibility and results of the laparoscopic management of symptomatic and large adrenal cysts.


METHODS
From June 1993 to April 2004 we performed 149 laparoscopic adrenalectomies. In this series 8 patients with symptomatic adrenal cysts or pseudocysts were treated laparoscopically. Surgical indications for laparoscopic management of adrenal cysts were abdominal pain in 5 cases and cyst size 5 cm or greater in 3.


RESULTS
The incidence of adrenal cyst was 5.4% (8 of 149 cases). Six patients underwent laparoscopic adrenal cyst decortication and marsupialization, 1 underwent laparoscopic partial adrenalectomy and 1 underwent laparoscopic adrenalectomy. Mean operative time was 77.5 minutes. There were no intraoperative or postoperative complications. Mean hospital stay was 1.7 days. At a mean followup of 18.5 months all patients were asymptomatic and without radiographic evidence of cyst recurrence.


CONCLUSIONS
Laparoscopic conservative management of adrenal cysts is safe and feasible. Laparoscopic decortication and marsupialization should be the preferred treatment option for symptomatic adrenal cysts. Laparoscopic partial adrenalectomy or a total adrenalectomy can be performed in cases of larger cysts which compromise most of the adrenal gland. To our knowledge, this represents the largest series of symptomatic adrenal cysts managed laparoscopically.
Castillo
Octavio A
OA
Section of Urology, Clinica Santa Maria, Department of Urology, Facultad de Medicina Oriente, Universidad de Chile, Santiago Chile.
Litvak
Juan P
JP
Kerkebe
Marcelo
M
Urena
Ruben D
RD
D000293:Adolescent; D000307:Adrenal Gland Diseases / Q000175:diagnosis / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D003560:Cysts / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged