title: Surgical management of adrenal cysts: single-institution experience.
abstract: OBJECTIVE
  To assess the safety and efficacy of different surgical procedures used for managing benign adrenal cysts.
  
  
  METHODS
  The files of 245 patients presenting with adrenal masses was reviewed retrospectively; all had a thorough history taken and a physical examination. The radiological evaluation included abdominal plain X-rays, grey-scale abdominal ultrasonography and computed tomography with contrast medium. According to their clinical situation, patients had surgical open, laparoscopic intervention or were managed conservatively. The short- and long-term outcome of the open and laparoscopic techniques were evaluated.
  
  
  RESULTS
  Twenty-six (11%) patients presented with adrenal cysts; the mean (sd, range) age at the time of presentation for adults was 41.4 (15, 17-82) years, while a 1-month female neonate and 1-year-old boy presented with an adrenal cyst. The mean (sd, range) size of the cysts was 10 (3.5, 5-18) cm. Surgical intervention was the treatment of choice in 21 patients; 11 (42%) had open adrenalectomy, while 10 (38%) had laparoscopic intervention. Both groups were comparable in the term of cyst size and operative time, while the laparoscopically managed group had a shorter hospital stay. Five patients were followed with no surgical intervention. At a mean follow-up of 90 months all patients were symptom free, with no radiological evidence of recurrence.
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy is a safe and effective treatment for benign adrenal cysts. Compared with open techniques it has the advantages of a shorter hospital stay, less blood loss and enhanced cosmesis. Unlike aspiration of cyst contents, the recurrence of adrenal cysts after surgical removal is unlikely.
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. a_s_elhefnawy@yahoo.com
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: El-Hefnawy
authors.forename: Muftah
authors.initials: M
authors.lastname: El Garba
authors.forename: Yasser
authors.initials: Y
authors.lastname: Osman
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Eraky
authors.forename: Mohsen
authors.initials: M
authors.lastname: El Mekresh
authors.forename: El-Housseiny
authors.initials: el-H
authors.lastname: Ibrahim
mesh_terms: D000293:Adolescent; D000307:Adrenal Gland Diseases / Q000601:surgery*; D000315:Adrenalectomy / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003560:Cysts / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult