title: Effect of laparoscopy on the indications for adrenalectomy.
abstract: BACKGROUND
  Laparoscopic adrenalectomy is now the criterion standard for removal of most benign adrenal lesions and may be used for malignant lesions as well. At the same time, improved imaging has led to an increase in the number of incidentally detected adrenal masses. The aim of this study was to determine whether the introduction of laparoscopy has changed the indications for adrenalectomy.
  
  
  METHODS
  Retrospective cohort study of patients operated on for primary adrenal disease between September 1, 1987, and August 17, 2007.
  
  
  METHODS
  Academic hospital.
  
  
  METHODS
  Sixty-six patients treated before (group 1) and 203 treated after (group 2) introduction of laparoscopic adrenalectomy.
  
  
  METHODS
  Patient characteristics, comorbidity, tumor size, indication, and time between diagnosis and surgery.
  
  
  RESULTS
  Group 2 had more patients in American Society of Anesthesiologists class III with gastrointestinal and metabolic-endocrine comorbidities. Tumor size did not change, and, despite an increase in the number of adrenalectomies, indications for surgery remained consistent over time.
  
  
  CONCLUSIONS
  Despite an increased volume of procedures, the introduction of laparoscopic adrenalectomy in our hospital did not change the indications for surgical intervention.
authors.affiliation: University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Daniel
authors.initials: D
authors.lastname: Henneman
authors.forename: Yuchiao
authors.initials: Y
authors.lastname: Chang
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hodin
authors.forename: David L
authors.initials: DL
authors.lastname: Berger
mesh_terms: D000307:Adrenal Gland Diseases / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies