ECE2009 Poster Presentations Adrenal (54 abstracts)
A multi-institutional audit of laparoscopic adrenalectomy in Greece and the UK
Panagiotis Kekis 1 , Haridimos Markogiannakis 1 , Nikolaos Michalopoulos 1 , Emmanuel Lagoudianakis 1 , Bill Fleming 2 , Alberto Martínez-Isla 3 , John Lynn 2 & Andreas Manouras 1
1Department of Endocrine Surgery, 1st Department of Propaedeutic Surgery, Athens Medical School, Hippokrateion Hospital, University of Athens, Athens, Greece; 2Department of Endocrine Surgery, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK; 3Department of Upper Gastrointestinal and Laparoscopic Surgery, Ealing Hospital, Ealing Hospital NHS Trust, London, UK.
Objective: To evaluate the results of laparoscopic adrenalectomy in our institutions.
Methods: Prospectively collected data from 2000 to 2007.
Results: During the 8-year study period, 160 laparoscopic adrenalectomies were performed in 150 patients. Mean age was 49.8 years (female: 60.7%). Twenty-seven patients (18%) had previous open abdominal operations. There were 10 bilateral (6.6%) for Cushing’s disease, 64 right (42.7%) and 76 left (50.7%) adrenalectomies. Diagnosis in unilateral cases was Conn’s syndrome in 43 patients (30.7%), non-functioning adenoma in 35 (25%), phaeochromocytoma in 26 (18.6%), Cushing’s syndrome in 20 (14.3%), metastasis in 8 (5.7%) and other in 8 (5.7%). Median tumour diameter was 4.0 cm, with 48 (30%) tumours >5.0 cm. In particular, 37 (23.1%) tumours were <3.0 cm, 75 (46.9%) were 3.0–5.0 cm, 9 (5.6%) 5.1–6.0 cm, 18 (11.2%) 6.1–7.0 cm, 14 (8.8%) 7.1–8.0 cm and 7 (4.4%) tumours were >8.0 cm. Median operative time was 130 min for bilateral and 55 min for unilateral procedures. Eleven cases (7.3%) underwent concurrent laparoscopic surgical procedures. Three adrenalectomies (1.8%) required conversion: a 10 cm phaeochromocytoma, a 4.5 cm phaeochromocytoma involving the renal artery and a 6.2 cm metastatic tumour extending to extra-adrenal tissues. Morbidity was 2.6% (n=4) and no mortality occurred. Median hospital stay was 48 h; five patients were discharged 5–8 h after the procedure.
Conclusions: Laparoscopic adrenalectomy, even for large tumours, is safe and effective when performed by surgeons highly experienced in laparoscopic endocrine surgery.
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