title: [Laparoscopic approach in the treatment of malignant adrenal tumours].
abstract: BACKGROUND
  Malignant primary or secondary adrenal tumours are uncommon. For most of them early surgery with adrenalectomy is the only means of cure. Although controversy exists on this issue, the increasing experience in laparoscopic surgery extends the indication for laparoscopic adrenalectomy to potentially malignant and to metastatic adrenal tumours. Our aim was to evaluate the technical feasibility of laparoscopic adrenalectomy for malignant neoplasias, describing the results of our consecutive series of patients.
  
  
  METHODS
  We retrospectively analysed 13 patients who underwent laparoscopic adrenalectomy for malignant neoplasia between March 1999 and June 2009, at the Hospital de Clínicas of the Universidad of Buenos Aires and at the Hospital Alemán of Buenos Aires. A transperitoneal laparoscopic approach was used in all patients. The mean follow up was 37.9 months (2-84).
  
  
  RESULTS
  Thirteen laparoscopic adrenalectomies were performed due to malignant neoplasia. Mean age was 55.2+12 years. The relationship between male and female was 10/3. Five patients had an adrenal carcinoma, 1 patient a malignant phaeochromocytoma, and 7 patients had metastatic tumours. Three patients required conversion to laparotomy. Average operation time was 146.4 min. There were two perioperative complications and no mortality. Average length of hospital stay was 4.6 days (1-35). The survival at 3 years was 46%. The cause of death was the underlying disease in all cases.
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy is a reasonable technique for malignant adrenal tumours, when the open oncological resection can be reproduced by the laparoscopic approach.
authors.affiliation: Departamento de Cirugía, Hospital Alemán de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Norberto Arístides
authors.initials: NA
authors.lastname: Mezzadri
authors.forename: Alexandra
authors.initials: A
authors.lastname: Catalina Mandry
authors.forename: Diego Luis
authors.initials: DL
authors.lastname: Sinagra
authors.forename: Jorge
authors.initials: J
authors.lastname: Eduardo Falco
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Fernández Vila
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged