Laparoscopic adrenalectomy for large adrenal masses: a challenge or a routine?
OBJECTIVE
The increased incidence of malignancy and the concern for higher rate of complications with laparoscopic resection of larger tumors typically limits laparoscopic adrenalectomy to small adrenal masses. We used our prospectively collected database to compare laparoscopic adrenalectomy outcomes between small and large adrenal tumors.


METHODS
Operative details and outcomes were compared by adrenal mass size size: Group A≤4 cm and Group B>4 cm, for consecutive laparoscopic adrenalectomies performed between 2009 and 2013.


RESULTS
Group A (N.=50) and Group B (N.=27) subjects had similar operative times (131 vs. 132 min, P=0.48). Group B subjects were older, had more adrenal malignancies, and had a higher blood loss with a slightly larger change in hemoglobin than Group A subjects; however, no subject required blood transfusion and complication rates were similar between groups (4% vs. 11%, P=0.34). One subject from each group required conversion to open adrenalectomy.


CONCLUSIONS
Laparoscopic adrenalectomy can be performed safely for adrenal masses >4 cm and size is not a contraindication to the laparoscopic approach.
Department of Surgery University Hospital of Parma, Parma, Italy - ziglioli@hotmail.it.
U
U
Maestroni
D
D
Vicente
P
P
Del Rio
F
F
Ziglioli
F
F
Dinale
D
D
Campobasso
S
S
Ferretti
A
A
Stojadinovic
I
I
Avital
D000310:Adrenal Gland Neoplasms / Q000473:pathology* / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies