title: Laparoscopic simultaneous bilateral partial and total adrenalectomy: a longer follow-up.
abstract: OBJECTIVE
  To examine the feasibility and safety of laparoscopic simultaneous bilateral adrenal surgery (LSBAS) and to compare the results between laparoscopic total adrenalectomy (TA) and partial adrenalectomy (PA).
  
  
  METHODS
  Between 1999 and January 2008, 12 patients underwent LBAS in our institution, with TA used in four with Cushing's disease refractory to pituitary surgery or radiation, in one with occult ectopic adrenocorticotropic hormone (ACTH) Cushing's syndrome, and one with bilateral adrenal macronodular hyperplasia. Six patients (five with primary aldosteronism and one with Cushing's syndrome) had bilateral functioning tumours had bilateral PAs.
  
  
  RESULTS
  All 12 operations were completed with no intraoperative complication, conversion, re-operation or death. The mean (range) operative duration was 323 (180-560) min, and the mean estimated blood loss was 79 (20-200) mL. There was adrenal insufficiency after surgery in three patients. Patients who had a PA had significantly longer surgery than those treated with TA, with a mean (sd) of 390 (36) vs 255 (27) min.
  
  
  CONCLUSIONS
  LSBAS is technically feasible; although surgery was longer than TA, bilateral PA in patients with bilateral functioning tumours mitigated the need for life-long steroid replacement.
authors.affiliation: Division of Urology, Department of Surgery, Cardinal Tien Hospital, Fu Jen Catholic University, Hsin Chuang, Taiwan.
authors.forename: Chun-Hou
authors.initials: CH
authors.lastname: Liao
authors.forename: Shiu-Dong
authors.initials: SD
authors.lastname: Chung
authors.forename: Ming-Kuen
authors.initials: MK
authors.lastname: Lai
authors.forename: Hong-Jeng
authors.initials: HJ
authors.lastname: Yu
authors.forename: Shih-Chieh
authors.initials: SC
authors.lastname: Chueh