The change in the principle of performing laparoscopic adrenalectomy from small to large masses.
BACKGROUND
Laparoscopic adrenalectomy has become the gold standard in most patients with adrenal tumors. It is unclear; however, at what size an adrenal neoplasm should be resected by means of an open or a laparoscopic approach. The aim of the present study was to compare the outcomes of laparoscopic adrenalectomy for large tumors with smaller tumors.


METHODS
A prospective study of patients who underwent adrenalectomy during the period 2006-2009 was undertaken. The patients were divided into 2 groups according to the tumor size. Group 1 (n=29) consisted of patients presenting tumors smaller than 5 cm in diameter; group 2 (n=31) consisted of patients with tumors larger than 5 cm in diameter.


RESULTS
Two of the 29 tumors in group 1 (6.8%) were malignant at final histology. However, 11 of the 31 tumors in group 2 (35.4%) were malignant. There were no significant differences between operating time and complications of groups 1 and 2. The intra-operative blood loss was significantly lower in group 1 than in group 2.


CONCLUSIONS
Laparoscopic adrenalectomy is a reasonable procedure for selected large adrenal tumors when a complete resection is technically feasible and there is no evidence of local invasion.
Erbil
Yeşim
Y
Istanbul University, Istanbul Medical Faculty, Department of General Surgery, 34340 Capa/Istanbul, Turkey. yerbil2003@yahoo.com
Barbaros
Umut
U
Karaman
Gülay
G
Bozbora
Alp
A
Ozarmağan
Selçuk
S
D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000704:Analysis of Variance; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome