title: Laparoscopic Transperitoneal Lateral Adrenalectomy for Large Adrenal Tumors.
abstract: BACKGROUND
  Laparoscopic adrenalectomy is the gold standard for treatment of benign adrenal lesions. Tumor size is a factor that might influence decision-making concerning the use of laparoscopic approach. The aim of this study was to analyze the results of adrenalectomy for tumors ≥6 cm in diameter.
  
  
  METHODS
  Two groups of patients were analyzed: first group comprised 441 patients with tumors <6 cm in diameter and second group consisted of 89 patients with tumors ≥6 cm. Both groups were compared with regard to the duration of surgery, intraoperative blood loss, conversion and complications rate.
  
  
  RESULTS
  Median duration of surgery in groups 1 and 2 amounted to 86.6 and 111.9 min (p < 0.0001), respectively. Median intraoperative blood loss in groups 1 and 2 was 56.5 and 172.8 ml (p < 0.0001), respectively. There was a linear relationship between tumor size and the duration of surgery, and between tumor size and intraoperative blood loss (p < 0.0001). There were 2 (0.5%) and 6 (6.7%) conversions in groups 1 and 2, respectively. There were 41 (9.3%) and 14 (15.7%) complications in groups 1 and 2 (p = 0.0692), respectively.
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy of tumors ≥6 cm is more difficult, but it can be regarded safe and beneficial for patients.
authors.affiliation: 2nd Department of General Surgery, Jagiellonian University, Krakow, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Natkaniec
authors.forename: Michał
authors.initials: M
authors.lastname: Pędziwiatr
authors.forename: Mateusz
authors.initials: M
authors.lastname: Wierdak
authors.forename: Piotr
authors.initials: P
authors.lastname: Major
authors.forename: Marcin
authors.initials: M
authors.lastname: Migaczewski
authors.forename: Maciej
authors.initials: M
authors.lastname: Matłok
authors.forename: Andrzej
authors.initials: A
authors.lastname: Budzyński
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Rembiasz
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D047368:Tumor Burden