title: The change in the principle of performing laparoscopic adrenalectomy from small to large masses.
abstract: 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.
authors.affiliation: Istanbul University, Istanbul Medical Faculty, Department of General Surgery, 34340 Capa/Istanbul, Turkey. yerbil2003@yahoo.com
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Erbil
authors.forename: Umut
authors.initials: U
authors.lastname: Barbaros
authors.forename: Gülay
authors.initials: G
authors.lastname: Karaman
authors.forename: Alp
authors.initials: A
authors.lastname: Bozbora
authors.forename: Selçuk
authors.initials: S
authors.lastname: Ozarmağan
mesh_terms: 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