title: Clinical outcomes of laparoscopic adrenalectomy according to tumor size.
abstract: OBJECTIVE
  In order to evaluate the indication and usefulness of laparoscopic adrenalectomy, clinical outcomes of laparoscopic adrenalectomy for patients with adrenal tumors were examined. Whether tumor size affects surgical outcome was analysed, along with the long-term clinical outcome for these patients.
  
  
  METHODS
  A total of 63 patients with adrenal tumor underwent laparoscopic adrenalectomy in our institute between 1999 and 2003. A laparoscopic transperitoneal approach was used in all cases. Underlying pathologies comprised Cushing syndrome (n = 12), pheochromocytoma (n = 13), primary aldosteronism (n = 21), non-functioning adenoma (n = 12) and others (n = 5).
  
  
  RESULTS
  No open conversion was performed. Mean operative duration was 239 min, and mean estimated blood loss was 134 mL. Tumor diameter was significantly smaller for primary aldosteronism than for Cushing syndrome, which in turn was significantly smaller than for adrenocorticotropic hormone-independent macronodular hyperplasia (AIMAH). No significant differences in surgical outcome and postoperative recovery were noted between large (>or=5 cm) and small (<5 cm) tumors. Long-term clinical outcome was better for patients with pheochromocytoma or primary aldosteronism than for patients with Cushing syndrome.
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy for benign tumor offers excellent surgical outcomes and convalescence. This is true for both small and large tumors.
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan. hara@med.kobe-u.ac.jp
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
authors.forename: Gaku
authors.initials: G
authors.lastname: Kawabata
authors.forename: Shoji
authors.initials: S
authors.lastname: Hara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yamada
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000473:pathology* / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome