title: Laparoscopic Adrenalectomy: First Single-Center Experience in the Balkans.
abstract: BACKGROUND
  Laparoscopic adrenalectomy has become the preferred approach for removal of the adrenal gland for the management of benign or malignant functioning or nonfunctioning adrenal masses. We aimed to present our initial experience with this procedure. In addition, we compare the clinical outcomes of laparoscopic (LA) vs. the open adrenalectomies (OA) performed at our institutions. Also we report a case of successful laparoscopic treatment of splenic artery aneurism involving laparoscopic splenectomy.
  
  
  METHODS
  A retrospective analysis of the data of all patients who underwent adrenalectomy at three institutions, over the last 12-year period, since the laparoscopic adrenal surgery was introduced in our country. All patients were assessed regarding the demographic data, hormonal status, operative time, estimated blood loss, complications, size of the tumor, number of patients requiring blood transfusion, hospital stay and conversion to open surgery for LA.
  
  
  RESULTS
  Thirty five consecutive patients, aged from 33 to 67 (average age 54 years) underwent unilateral LA adrenalectomy during the study period including 14 right and 21 left sided. The laparoscopic procedure was successfully completed in all except 4 cases, which were converted to open surgery to control bleeding from the avulsed adrenal veins. LA proved superior to OA, resulting in less estimated blood loss, shorter operating time, shorter time to resumption of oral intake, shorter postoperative hospital stay and less analgesic requirements. During the follow-up of 3 to 36 months no tumor recurrence and/or metastasis developed.
  
  
  CONCLUSIONS
  Our results concur with other retrospective reviews comparing laparoscopic and open adrenalectomy, demonstrating unequivocal advantages in terms of reduced length of hospital stay, blood loss, return of bowel function, functional recovery and post-operative morbidity.
authors.forename: Zivko
authors.initials: Z
authors.lastname: Popov
authors.forename: Nikola
authors.initials: N
authors.lastname: Jankulovski
authors.forename: Oliver
authors.initials: O
authors.lastname: Stankov
authors.forename: Sotir
authors.initials: S
authors.lastname: Stavridis
authors.forename: Skender
authors.initials: S
authors.lastname: Saidi
authors.forename: Marjan
authors.initials: M
authors.lastname: Kuzmanoski
authors.forename: Igor
authors.initials: I
authors.lastname: Chipurovski
authors.forename: Sasho
authors.initials: S
authors.lastname: Banev
authors.forename: Branka
authors.initials: B
authors.lastname: Krstevska
authors.forename: Ognen
authors.initials: O
authors.lastname: Ivanovski
authors.forename: Chedomir
authors.initials: C
authors.lastname: Dimitrovski
mesh_terms: D000315:Adrenalectomy / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000783:Aneurysm / Q000175:diagnosis / Q000601:surgery*; D063368:Balkan Peninsula; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D061887:Conversion to Open Surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D018843:Republic of North Macedonia; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D013157:Splenic Artery / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000700:Analgesics