Abstract

TORRES PENA, Rafael et al. Learnt lessons from laparoscopic adrenalectomy . Rev Cubana Endocrinol [online]. 2014, vol.25, n.3, pp.216-230. ISSN 1561-2953.

Introduction: laparoscopic adrenalectomy has turned into the standard treatment of functional and non-functional benign diseases in the adrenal glands. This study was aimed at evaluating the results of the laparoscopic adrenalectomy in the National Center of Minimal Access Surgery. Methods: a descriptive, observational and prospective study was conducted from February 2001 through September 2011 in which laparoscopic adrenalectomies performed to 36 patients. The preoperative diagnostic assessment was made at the National Institute of Endocrinology and the surgical treatment was prescribed in the National Center of Minimal Access Surgery, both based on the multicenter and multidisciplinary management. The preoperative diagnosis-related parameters, the surgical procedure details and the postoperative care were all statistically analyzed. Results: left adrenal gland was removed from 18 patients, the right one was removed in 13 and both glands in 5 patients. 75.6% of surgeries were performed in patients with functioning disease, endogenous hypercortisolism (25), primary hyperaldosteronism (3) and pheochromocytoma (3). Prescriptions for incidentalomas were less frequent. The mean age of patients was 41 years (range of 21-65); the average surgical time was 210 minutes (range of 90-360); the average intraoperative bleeding was 84mL (range of 10-400); the average size of tumor was 4.6 cm (range of 0.9-8.5). There were two conversions which are statistically correlated with over 5 cm tumors (p= 0.046). Intraoperative complications were unreported whereas surgical wound sepsis affected 2 patients. Mortality was null. Conclusions: the multicenter and multidisciplinary approach, based on experiences in endocrine management and laparoscopic access of two Cuban reference centers, allowed achieving excellent functional results, minimal perioperative morbidity and null mortality.

Keywords : adrenal glands; adrenalectomy; laparoscopy.

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