Langenbeck's archives of surgery · 2025
Does size still matter? - Feasibility of posterior retroperitoneoscopic adrenalectomy for tumors >6cm.
СтатьяНазвание и аннотация: Перевод в очереди
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Feka Joy, Soliman Barbara, Arikan Melisa, Sacher Magdalena, Binter Teresa, Hargitai Lindsay, Scheuba Christian, Riss Philipp
Аннотация
PURPOSE: Retroperitoneoscopic adrenalectomy (RPA) has proven to be safe and feasible with favorable postoperative courses. The role of RPA for tumor sizes larger than 6 cm is still controversial. The aim of the study was to evaluate the postoperative outcome for removal of larger adrenal tumors via the retroperitoneoscopic route.
METHODS: In this retrospective study, from 105 conducted RPA procedures, thirteen patients with adrenal tumor sizes larger than 6 cm received RPA in our hospital between January 2017 and December 2020. Clinicopathological factors, length of hospital stay, operative time and postoperative outcomes were included in this analysis.
RESULTS: From this patient cohort, six (46.15%) were female and seven (53.85%) were male with a mean age of 53.85 ± 7.89 years and a mean BMI of 28.64 ± 3.61 kg/m2, Cushing's syndrome being the most common diagnosis (53.85%). Mean lesion size was 73.31 ± 10.39 mm, tumor size varied from 60 mm up to 92 mm. Two patients (15.38%) required conversion to open laparotomy due to uncontrollable bleeding or an unclear view on the basis of adhesions. Postoperative complications were noted for one patient (7.69%), who suffered from a small superficial wound infection. Neither capsule ruptures nor mortality were documented. The median hospital stay was 3 days.
CONCLUSION: A re-evaluation of the arbitrarily placed cut-off should be discussed, since even with a slightly higher but nevertheless acceptable risk of conversion rate, RPA offers many advantages.
METHODS: In this retrospective study, from 105 conducted RPA procedures, thirteen patients with adrenal tumor sizes larger than 6 cm received RPA in our hospital between January 2017 and December 2020. Clinicopathological factors, length of hospital stay, operative time and postoperative outcomes were included in this analysis.
RESULTS: From this patient cohort, six (46.15%) were female and seven (53.85%) were male with a mean age of 53.85 ± 7.89 years and a mean BMI of 28.64 ± 3.61 kg/m2, Cushing's syndrome being the most common diagnosis (53.85%). Mean lesion size was 73.31 ± 10.39 mm, tumor size varied from 60 mm up to 92 mm. Two patients (15.38%) required conversion to open laparotomy due to uncontrollable bleeding or an unclear view on the basis of adhesions. Postoperative complications were noted for one patient (7.69%), who suffered from a small superficial wound infection. Neither capsule ruptures nor mortality were documented. The median hospital stay was 3 days.
CONCLUSION: A re-evaluation of the arbitrarily placed cut-off should be discussed, since even with a slightly higher but nevertheless acceptable risk of conversion rate, RPA offers many advantages.