title: Ten years of laparoscopic adrenalectomy: lesson learned from 104 procedures.
abstract: The purpose of this study was to evaluate the short- and long-term results of 104 consecutive laparoscopic adrenalectomies performed during a period of 10 years in two specialist centers. One hundred four patients underwent laparoscopic adrenalectomy in two specialist centers in Italy between 1994 and 2003. Indications to laparoscopic adrenalectomy were aldosterone-secreting adenoma (20%), pheochromocytoma (24%), cortisol-secreting adenoma (11.5%), incidentaloma (26.9%), multiple endocrine neoplasia (MEN) type 2A (2.8%), adrenal metastases from lung cancer (3.8%), adrenal cyst (6.7%), and angiomyolipoma (3.8%). Transperitoneal anterior and lateral approaches were adopted in 17 and 84 patients, respectively. Retroperitoneal approach was adopted in three patients. Mean operative time was 108 +/- 39.1 minutes (range, 40-300 minutes). There was no correlation between adrenal tumor diameter and operative time. Mean intraoperative blood loss was 106 mL (range, 40-600 mL). Intraoperative complication rate and conversion rate were 4.8 per cent (5 cases). Laparoscopic adrenalectomy is a safe procedure. After a relatively short learning curve, it can be performed successfully by any surgeon with low operative morbidity and mortality. The size of the adrenal tumor should not be considered a contraindication to this procedure.
authors.affiliation: University of Rome "La Sapienza," II Faculty of Medicine and Surgery, Azienda Ospedaliera Sant'Andrea, Hepatobiliary and Pancreatic Surgery, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ramacciato
authors.forename: Mercantini
authors.initials: M
authors.lastname: Paolo
authors.forename: Amodio
authors.initials: A
authors.lastname: Pietromaria
authors.forename: Buniva
authors.initials: B
authors.lastname: Paolo
authors.forename: D'Angelo
authors.initials: D
authors.lastname: Francesco
authors.forename: Petrocca
authors.initials: P
authors.lastname: Sergio
authors.forename: Stigliano
authors.initials: S
authors.lastname: Antonio
authors.forename: Toscano
authors.initials: T
authors.lastname: Vincenzo
authors.forename: Piccoli
authors.initials: P
authors.lastname: Micaela
authors.forename: Melotti
authors.initials: M
authors.lastname: Gianluigi
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000209:etiology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods* / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome