Laparoscopic transperitoneal lateral adrenalectomy for malignant and potentially malignant adrenal tumours

BMC Surgery

Research Article

Michał Pędziwiatr¹  Piotr Budzyński¹  Piotr Major¹  Maciej Matłok¹  Andrzej Budzyński¹  Michał Natkaniec¹  Alicja Hubalewska-Dydejczyk²  Magdalena Białas³  Mateusz Wierdak⁴ 

[1] 2nd Department of General Surgery, Jagiellonian University, Kopernika 21, 31-501, Kraków, Poland;Department of Endocrinology, Jagiellonian University, Kopernika 17, 31-531, Kraków, Poland;Department of Pathology, Jagiellonian University, Grzegórzecka 16, 31-531, Kraków, Poland;Department of Physiology, Jagiellonian University, Grzegórzecka 16, 31-531, Kraków, Poland;

关键词: Adrenocortical cancer;    Pheochromocytoma;    Adrenal metastasis;    Laparoscopic adrenalectomy;   

DOI  :  10.1186/s12893-015-0088-z

 received in 2015-01-07, accepted in 2015-08-21,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundLaparoscopic adrenalectomy is still controversial in cases where malignancy is suspected. However, many proponents of this technique argue that in the hands of an experienced surgeon, laparoscopy can be safely performed. The aim of this study is to present our own experience with the application of laparoscopic surgery for the treatment of malignant and potentially malignant adrenal tumours.MethodsOur analysis included 52 patients who underwent laparoscopic adrenalectomy in 2003–2014 due to a malignant or potentially malignant adrenal tumour. Inclusion criteria were primary adrenal malignancy, adrenal metastasis or pheochromocytoma with a PASS score greater than 6. We analyzed the conversion rate, intra- and postoperative complications, intraoperative blood loss and R0 resection rate. Survival was estimated using the Kaplan-Meier method.ResultsConversion was necessary in 5 (9.7 %) cases. Complications occurred in a total of 6 patients (11.5 %). R0 resection was achieved in 41 (78.8 %) patients and R1 resection in 9 (17.3 %) patients. In 2 (3.9 %) cases R2 resection was performed. The mean follow-up time was 32.9 months. Survival depended on the type of tumour and was comparable with survival after open adrenalectomy presented in other studies.ConclusionsWe consider that laparoscopic surgery for adrenal malignancy can be an equal alternative to open surgery and in the hand of an experienced surgeon it guarantees the possibility of noninferiority. Additionally, starting a procedure with laparoscopy allows for minimally invasive evaluation of peritoneal cavity. The key element in surgery for any malignancy is not the surgical access itself but the proper technique.

【 授权许可】

CC BY   
© Pędziwiatr et al. 2015