Laparoscopic Adrenalectomy: Lessons Learned From 100 Consecutive Procedures

摘要: UNLABELLED One hundred consecutive laparoscopic adrenal procedures for a variety of endocrine disorders were reviewed. There was no mortality, morbidity 12%, and conversions 3%. During follow-up, none had recurrence hormonal excess. Laparoscopic adrenalectomy is the procedure choice removal except in carcinoma or masses > 15 cm. OBJECTIVE The authors evaluate effectiveness disorders. SUMMARY BACKGROUND DATA Since first performed 1992, this approach quickly has been adopted, increasing numbers are being reported. However, follow-up period too short to completeness these operations. METHODS from January 1992 until November 1996 reviewed followed adequacy resection. RESULTS Eighty-eight patients underwent 97 adrenalectomies biopsies. mean age 46 years (range, 17-84 years). Indications pheochromocytomas (n = 25), aldosterone-producing adenomas 21), nonfunctional 20), cortisol-producing 13), Cushing's disease 8), others 13). Fifty-five previous abdominal surgery. Mean operative time 123 minutes 80-360 minutes), estimated blood loss 70 mL 20-1300 mL). encountered 12% patients, including three whom venous thrombosis developed with two sustaining pulmonary emboli. pheochromocytoma removal, hypertension occurred 56% hypotension 52%. open average length stay decreased 3 days 2-19 days) 2.4 1-6 over past 16 months. 1-44 months), renovascular CONCLUSION safe, effective, decreases hospital wound complications. Prior surgery not contraindication. Pheochromocytomas can be resected safely laparoscopically despite pressure variations. Venous prophylaxis mandatory. case invasive