Should we use laparoscopic adrenalectomy for metastases? Scandinavian multicenter study.
BACKGROUND
Laparoscopic adrenalectomy for metastases is considered controversial. Multicenter retrospective study was performed to gain new knowledge in this issue.


METHODS
From January 1997 till November 2008, 41 adrenalectomies were performed during follow-up of the patients operated for malignant tumors. The median age was 64 (52-77) years. Metastases were confirmed in 31/41 cases. Metastatic lesions were further studied and to define factors influencing on survival, patients were divided to sub-groups of metachronous/synchronous, tumor origin and tumor size.


RESULTS
The median operative time was 104 (50-230) min, the median blood loss was 100 (0-500) ml. One procedure (3.2%) was converted. There were 3 (10.7%) intraoperative and 2 (7.4%) postoperative complications. The median tumor size was 6 (1.5-16) cm. Pathohistological analysis revealed 12 colorectal, 9 renal cell carcinoma, 5 lung carcinoma, 4 melanoma, and 1 hepatocellular metastases. The resection margin was not free in one case (3.7%). The median hospital stay was 2 (1-21) days. The median length of survival was 29 +/- 2.1 months for all patients.


CONCLUSIONS
Laparoscopic adrenalectomy for metastases is feasible regardless of their sizes. However these procedures should be performed by highly skilled laparoscopic surgeon in a fully equipped operating room and with a coordinated operation team.
Interventional Centre, Rikshospitalet University Hospital, Oslo, Norway. irinapavlik25@gmail.com
Irina Pavlik
IP
Marangos
Airazat M
AM
Kazaryan
Arne R
AR
Rosseland
Bård I
BI
Røsok
Hege S
HS
Carlsen
Bjarne
B
Kromann-Andersen
Bjørn
B
Brennhovd
Hans J
HJ
Hauss
Karl-Erik
KE
Giercksky
Øystein
Ø
Mathisen
Bjørn
B
Edwin
D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies