title: Laparoscopic surgery for adrenal tumors. A retrospective analysis.
abstract: OBJECTIVE
  Laparoscopic adrenalectomy has rapidly replaced open adrenalectomy as the procedure of choice for benign adrenal tumors. The aim of this study was to evaluate the short- and long-term results of 100 consecutive laparoscopic and open adrenalectomies performed during a period of 8.5 years in our Surgical Unit.
  
  
  METHODS
  A retrospective analysis of patients operated on for adrenal tumors was conducted. From May 1997 to August 2005, one hundred adrenalectomies were performed on 95 patients. Five patients underwent either synchronous or metachronous bilateral adrenalectomy. There were 38 men and 57 women, aged 16 to 80 years. The size of tumors in our series ranged from 3.2 to 27 cm. The largest laparoscopically excised tumor was a ganglioneuroma with a diameter of 13 cm.
  
  
  RESULTS
  In 73 patients laparoscopic procedure was completed successfully. In 8 cases the laparoscopic procedure was converted to open. Fourteen patients were treated with open approach. One patient with pheochromocytoma succumbed following pulmonary embolus. In one patient with morbid obesity, Cushing's syndrome, and bilateral adrenal macronodular hyperplasia, the left laparoscopic adrenalectomy was complicated by a low output pancreatic fistula, conservatively treated. All other patients had an uneventful course. Operative time for laparoscopic adrenalectomies ranged from 65 to 180 minutes. The average postoperative hospital stay for laparoscopic adrenalectomy ranged from 1 to 2 days (1.5 days), versus 5 to 20 days for patients who underwent open or converted procedure.
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy should be the treatment of choice for all benign adrenal tumors. Laparoscopic resection of large adrenal tumors necessitates experience in open surgery and advanced laparoscopic surgery.
authors.affiliation: Third Department of Surgery, Athens General Hospital G. Gennimatas, Athens, Greece. gnzografos@yahoo.com
authors.forename: George N
authors.initials: GN
authors.lastname: Zografos
authors.forename: Athina
authors.initials: A
authors.lastname: Markou
authors.forename: Chrisanthi
authors.initials: C
authors.lastname: Ageli
authors.forename: Nikos
authors.initials: N
authors.lastname: Kopanakis
authors.forename: Spiros
authors.initials: S
authors.lastname: Koutmos
authors.forename: Gregory
authors.initials: G
authors.lastname: Kaltsas
authors.forename: George
authors.initials: G
authors.lastname: Piaditis
authors.forename: George
authors.initials: G
authors.lastname: Papastratis
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D010673:Pheochromocytoma / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome