title: [Laparoscopic adrenalectomy. Five-year experience].
abstract: OBJECTIVE
  Adrenal conditions requiring surgery are uncommon and are usually seen in several surgical departments. Our experience in laparoscopic management of adrenal pathology after almost five years of use of laparoscopy for retroperitoneal conditions at our center is reported.
  
  
  METHODS
  A total of 37 laparoscopic adrenalectomies were performed over 53 months for benign and malignant conditions. The transperitoneal approach was used in most cases (97%) because of the greater surgeon experience with this route. Pregnancy and suspected periadrenal infiltration were considered as absolute contraindications.
  
  
  RESULTS
  Mean operating time was 90 minutes, mean intraoperative bleeding 80 ml, and mean hospital stay was 2 days. The main complication was one death. A malignancy was found in 4 patients (10%), while all other patients (90%) had a benign condition, including 8 pheochromocytomas.
  
  
  CONCLUSIONS
  Laparoscopy is considered to be the gold standard for benign adrenal conditions. When the malignant mass is a single metastasis from a primary tumor, the laparoscopic approach appears to be reliable. When the malignant lesion is a primary adrenal tumor, laparoscopic management is more controversial, although the results reported by experienced surgeons in their series appear to be adequate.
authors.affiliation: Servicio de Urología, Hospital Universitario La Paz, Madrid, España. aaguilera11@yahoo.es
authors.forename: A
authors.initials: A
authors.lastname: Aguilera Bazán
authors.forename: M
authors.initials: M
authors.lastname: Pérez Utrilla
authors.forename: C
authors.initials: C
authors.lastname: Alvarez Escolá
authors.forename: J
authors.initials: J
authors.lastname: Reinoso
authors.forename: A
authors.initials: A
authors.lastname: Fernández Martínez
authors.forename: J
authors.initials: J
authors.lastname: Cisneros Ledo
authors.forename: J
authors.initials: J
authors.lastname: de la Peña Barthel
mesh_terms: D000236:Adenoma / Q000601:surgery; D000307:Adrenal Gland Diseases / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000556:secondary / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods* / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000556:secondary / Q000601:surgery; D000075202:Contraindications; D003480:Cushing Syndrome / Q000601:surgery; D003560:Cysts / Q000601:surgery; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000601:surgery; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D018209:Myelolipoma / Q000601:surgery; D010673:Pheochromocytoma / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery; D012189:Retrospective Studies