title: [Laparoscopic adrenalectomy for isolated metastasis of adrenal glands].
abstract: OBJECTIVE
  The treatment of adrenal metastases using laparoscopic surgery still remains a matter of considerable controversy. The aim of this study is to present our experience of laparoscopic adrenalectomy for isolated adrenal metastasis.
  
  
  METHODS
  From June 2004 to June 2011, 5 adults (4 males/1 female) with isolated metastases to the adrenal glands underwent laparoscopic adrenalectomy. These patients included 3 cases of lung carcinoma, a case of hepatocellular carcinoma, and a case of renal cell carcinoma. The median patient age was 69 (range 61 to 72), and the median tumor size was 3.5 cm (range 2.5 to 7.0).
  
  
  RESULTS
  Laparoscopic adrenalectomies were performed without any complications using transperitoneal and retroperitoneal approaches. The median operative time was 142 minutes (range 126 to 174), and the estimated blood loss was 38 ml (range 25 to 158). The resection margins were free in all cases. A patient with lung cancer has been treated with adjuvant chemotherapy, otherwise, 4 patients have not. Regarding the oncological outcome, 3 of 5 patients were alive without any recurrence at a median follow-up of 14 months. About the rest two cases, one was alive with lung metastasis occurred at 15 months later, the other was died of the cancer at 14 months later.
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy for isolated adrenal metastasis is thought to be feasible. However, the indication of the surgery must be determined depending on tumor size, cancer characteristics, risk factors and so on. Additionally, the operative procedures such as approaches must be discussed sufficiently.
authors.affiliation: Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Zakoji
authors.forename: Shoji
authors.initials: S
authors.lastname: Kudo
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Inuzuka
authors.forename: Satoru
authors.initials: S
authors.lastname: Kira
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Takeda
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000556:secondary* / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged