title: Is laparoscopic adrenalectomy safe and effective for adrenal masses larger than 7 cm?
abstract: BACKGROUND
  Laparoscopic adrenalectomy (LA) has become the gold standard treatment for small (less than 6 cm) adrenal masses. However, the role of LA for large-volume (more than 6 cm) masses has not been well defined. Our aim was to evaluate, retrospectively, the outcome of LA for adrenal lesions larger than 7 cm.
  
  
  METHODS
  18 consecutive laparoscopic adrenalectomies were performed from 1996 to 2005 on patients with adrenal lesions larger than 7 cm.
  
  
  RESULTS
  The mean tumor size was 8.3 cm (range 7-13 cm), the mean operative time was 137 min, the mean blood loss was 182 mL (range 100-550 mL), the rate of intraoperative complications was 16%, and in three cases we switched from laparoscopic procedure to open surgery.
  
  
  CONCLUSIONS
  LA for adrenal masses larger than 7 cm is a safe and feasible technique, offering successful outcome in terms of intraoperative and postoperative morbidity, hospital stay and cosmesis for patients; it seems to replicate open surgical oncological principles demonstrating similar outcomes as survival rate and recurrence rate, when adrenal cortical carcinoma were treated. The main contraindication for this approach is the evidence, radiologically and intraoperatively, of local infiltration of periadrenal tissue.
authors: Department of Surgery, University of Rome La Sapienza, II(o) School of Medicine, Azienda Ospedaliera Sant' Andrea Via di Grottarossa 1035, 1039 00189, Rome, Italy. giovanni.ramacciato@uniroma1.it
authors: Giovanni
authors: G
authors: Ramacciato
authors: Paolo
authors: P
authors: Mercantini
authors: Marco
authors: M
authors: La Torre
authors: Fabrizio
authors: F
authors: Di Benedetto
authors: Giorgio
authors: G
authors: Ercolani
authors: Matteo
authors: M
authors: Ravaioli
authors: Micaela
authors: M
authors: Piccoli
authors: Gianluigi
authors: G
authors: Melotti
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000473:pathology* / Q000601:surgery*; D000315:Adrenalectomy / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged
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