Archivos espanoles de urologia · 2011
Laparoscoscopic synchronous bilateral adrenalectomy.
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Castillo Octavio A, López-Fontana Gastón, Vitagliano Gonzalo
Аннотация
OBJECTIVES: To report our experience in a series of bilateral synchronous laparoscopic adrenalectomies detailing technique and results.
METHODS: A total of 242 laparoscopic adrenalectomies were performed in an 8 year period at our institution. Twenty four out of these were bilateral. Of the 24 patients, 22 (92%) were bilateral and synchronous. Mean patient age was 41.4 years (range 17 to 72 years) and male to female ratio was 1:2.1.
RESULTS: Mean adrenal size was 5.5 cm (range 2 to 11 cm). In order of frequency, pathological finding was: pheochromocytoma, cushing`s disease, metastatic lesions, hyperaldosteronism, congenital adrenal hyperplasia, myelolipoma and adrenal adenoma. Complete adrenalectomy was performed in 36 cases (82%) while in 8 cases (18%) partial adrenalectomy was preferred. Mean operative time was 78.6 minutes (range 25 to 210 min) being 79.5 min and 77 min for right and left adrenalectomies respectively. Mean operative bleeding was 63 ml (range 0 to 500 ml). Only one patient received blood transfusion. Intraoperative complications occurred in only one patient (2%), a small tear in the renal vein that was successfully controlled by intracorporeal suturing. Mean hospital stay was 3.2 days (range 2 to 5 days).
CONCLUSION: We believe that laparoscopic synchronous bilateral adrenalectomy is a feasible, safe and reproducible technique that should be considered of choice for the management of benign bilateral adrenal pathology.
METHODS: A total of 242 laparoscopic adrenalectomies were performed in an 8 year period at our institution. Twenty four out of these were bilateral. Of the 24 patients, 22 (92%) were bilateral and synchronous. Mean patient age was 41.4 years (range 17 to 72 years) and male to female ratio was 1:2.1.
RESULTS: Mean adrenal size was 5.5 cm (range 2 to 11 cm). In order of frequency, pathological finding was: pheochromocytoma, cushing`s disease, metastatic lesions, hyperaldosteronism, congenital adrenal hyperplasia, myelolipoma and adrenal adenoma. Complete adrenalectomy was performed in 36 cases (82%) while in 8 cases (18%) partial adrenalectomy was preferred. Mean operative time was 78.6 minutes (range 25 to 210 min) being 79.5 min and 77 min for right and left adrenalectomies respectively. Mean operative bleeding was 63 ml (range 0 to 500 ml). Only one patient received blood transfusion. Intraoperative complications occurred in only one patient (2%), a small tear in the renal vein that was successfully controlled by intracorporeal suturing. Mean hospital stay was 3.2 days (range 2 to 5 days).
CONCLUSION: We believe that laparoscopic synchronous bilateral adrenalectomy is a feasible, safe and reproducible technique that should be considered of choice for the management of benign bilateral adrenal pathology.