Endocrine Abstracts

Aim of the study: Presenting the changes in surgical management and patients’ characteristics based on a single-center data.

Material and method: From 29/10/1997 to 31/04/2011 824 adrenalectomies were carried out, 641 (78%) laparoroscopic and 183 (22%) open. In all cases of laparoscopic adrenalectomy (LA) lateral transabdominal approach was used. Bilateral simultaneous adrenalectomy with the changing patient position was performed for bilateral pheochromocytoma, while in hypercortisolemia two-stage adrenalectomy with time interval was preffered. Indication for LA in 349 (54%) were hormonal active lesions, in 292 (46%) non-active lesions. In this study the characteristics of patients, size of the tumor and technical aspects of laparoscopy were compared between two periods: 1997–2005 and 2006–2011.

Results: The number of patients operated due to hormonal active lesions increased (53.4 vs 55.2%), mainly due to hypercortisolemia (34.6 vs 39.5%) and pheochromocytoma (33.6 vs 39.5%). The higher incidence of patients with hypercortisolemia is a result of rise of cases of Cushing’s disease (2.5 vs 4.5%) and pre-Cushing’s syndrome (16.1 vs 18%). The amount of cases with Cushing’s syndrome didn’t change significantly (16.8 vs 17%). In the same time the number of patients with Conn’s syndrome has decreased (30.9 vs 19%). Among non-active tumors: the amount of adenomas inreased (63.8 vs 72.2%), while the remaining number of cases lowered (46.6 vs 44.8%). Distribution of tumors size was comparable. The number of tumors with diameter: < 4 cm was 46%, ≧ 4<6 cm - 33%, ≧6<8 cm - 16% and ≧ 8 cm - 5%.

Conclusion: Laparoscopic operations became recommended method of surgical treatment of adrenal pathology. Despite greater availability of imaging exams which increase detection of adrenal diseases the proportion between the active and non-active lesions qualified for laparoscopy hasn’t changed significantly.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.