Transperitoneal laparoscopic surgery in large adrenal masses

Nuri Alper Sahbaz; Ahmet Cem Dural; Cevher Akarsu; Deniz Guzey; Mehmet Kulus; Sema Ciftci Dogansen; Meral Mert; Halil Alis

doi:10.5114/wiitm.2019.85177

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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abstract:

Original paper

Transperitoneal laparoscopic surgery in large adrenal masses

Nuri Alper Sahbaz

¹

,

Ahmet Cem Dural

¹

,

Cevher Akarsu

¹

,

Deniz Guzey

¹

,

Mehmet Kulus

¹

,

Sema Ciftci Dogansen

²

,

Meral Mert

²

,

Halil Alis

³

Department of Surgery, Faculty of Medicine, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
Department of Endocrinology, Faculty of Medicine, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
Department of Surgery, Faculty of Medicine, Aydin University, VM Medical Park Florya Hospital, Istanbul, Turkey

Videosurgery Miniinv 2020; 15 (1): 106–111

DOI: https://doi.org/10.5114/wiitm.2019.85177

Online publish date: 2019/05/15

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Introduction
The laparoscopic adrenalectomy (LA) has become the gold standard since the transperitoneal laparoscopic approach was first reported.

Aim
To evaluate the applicability, safety and short-term results of laparoscopic surgery in adrenal masses over 6 cm.

Material and methods
Demographic data, hormonal activities, imaging modalities, operative findings, operation time, conversion rates, complications, duration of hospital stay and histopathologic results of 128 patients who underwent laparoscopic adrenalectomy were evaluated retrospectively. Patients included in the learning curve (n = 23), robotic surgery cases (n = 15) and patients with suspected metastasis (n = 4) were excluded from the study. Six cm mass size was taken as a reference and two groups were formed (group 1: < 6 cm, group 2: ≥ 6 cm). The results of the two groups were compared.

Results
There were 64 cases in group 1 and 22 cases in group 2. Functional mass ratio and mass sides were similar between the groups (p = 0.30 and p = 0.17, respectively). The mean mass size in group 1 was 36.4 ±11.2 mm and in group 2 82.4 ±15.5 mm. The conversion rate was similar between the two groups (p = 0.18). The duration of surgery was 135.5 ±8.29 min in group 1, 177.0 ±14.9 min in group 2 (p = 0.014). Morbidity and lengths of hospital stay were similar (p = 0.76, p = 0.34 respectively). Adrenocortical carcinoma was detected in three cases in group 1, which were completed laparoscopically, and in two cases in group 2, which were converted to open surgery (p = 0.46).

Conclusions
Although open surgery is still recommended in the guidelines, studies are now being carried out to ensure that laparoscopy can be safely performed on masses over 6 cm. There was no difference between short-term follow-up and histopathologic results in our study.

keywords:

Transperitoneal laparoscopic surgery in large adrenal masses

Nuri Alper Sahbaz 1 , Ahmet Cem Dural 1 , Cevher Akarsu 1 , Deniz Guzey 1 , Mehmet Kulus 1 , Sema Ciftci Dogansen 2 , Meral Mert 2 , Halil Alis 3

large adrenal tumors, adrenalectomy, laparoscopy, minimally invasive adrenalectomy

Nuri Alper Sahbaz

¹

,

Ahmet Cem Dural

¹

,

Cevher Akarsu

¹

,

Deniz Guzey

¹

,

Mehmet Kulus

¹

,

Sema Ciftci Dogansen

²

,

Meral Mert

²

,

Halil Alis

³