Partial laparoscopic adrenalectomy for aldosteronoma: our experience

Autor: Misir, Zvonimir, Glavčić, Goran, Janković, Suzana, Filipović-Čugura, Jakša
Rok vydání: 2021
Předmět:
Zdroj: Libri Oncologici, Vol 49, Iss 2-3, Pp 72-75 (2021)
Libri Oncologici : Croatian Journal of Oncology
Volume 49
Issue 2-3
ISSN: 2584-3826
0300-8142
Popis: Background: Since its first description in 1992, laparoscopic adrenalectomy has become the gold standard for the surgical treatment of most adrenal conditions. We demonstrated the safety and feasibility of the laparoscopic technique in patients with primary hyperaldosteronism caused by solitary aldosteronoma treated by laparoscopic partial adrenalectomy. Aim: To demonstrate safety and feasibility of laparoscopic partial adrenalectomy in aldosterone-producing adenomas. Materials and methods: From 1992. to the present time, 13 patients presented with hyperaldosteronism and a single adrenal adenoma (Conn’s syndrome) and were treated with laparoscopic partial adrenalectomy. The mean age was 65 years, and the average tumor size was 1.35 cm in diameter. The mean follow-up of our patients for hypertension and local reccurence was 36 months (range 6 – 72 months). A transperitoneal approach was used in all patients, tumors were resected with safety margins by ultrasonic device. Results: All procedures were finished laparoscopically, and no conversion was necessary. The mean duration of the operations was 65 minutes, with a mean bleeding rate of 40 ml. No major intraoperative or postoperative complication was observed. Postoperative mean hospital stay was 4 days. In all the cases, hypertension improved totally or partially, and no local recurrence was observed. Conclusion: Laparoscopic partial adrenalectomy for aldosterone-producing adenomas is a minimally invasive procedure with a low complication rate. This procedure can be performed with good results for patients with small aldosteronomas of the adrenal gland, even with a healthy contralateral adrenal gland.
Uvod: Od kada je po prvi puta opisana, laparoskopska adrenalektomija postala je zlatni standard u liječenju većine tumora nadbubrežne žlijezde. Pokazali smo sigurnost laparoskopskog pristupa kod bolesnika s primarnim hiperaldosteronizmom uzrokovanog solitarnim aldosteronomom liječenih djelomičnom adrenalektomijom. Cilj: Pokazati sigurnost i izvedivost laparoskopske djelomične adrenalektomije kod adenoma koji luče aldosteron. Materijali i metode: Od 1992. godine do danas, 13 bolesnika s primarnim hiperaldosteronizmom uzrokovanim solitarnim adenomom nadbubrežne žlijezde bilo je liječeno djelomičnom laparoskopskom adrenalektomijom. Prosječna dob bolesnika bila je 65 godina i veličina tumora 1,35 cm u promjeru. Pacijenti su praćeni kroz prosječno razdoblje od 36 mjeseci (raspon od 6-72 mjeseca). Kod svih bolesnika korišten je transperitonealni pristup pri čemu je za resekciju tumora korišten ultrazvučni nož. Rezultati: Svi operacijski postupci završeni su laparoskopski, bez potrebe za konverzijom. Prosječno trajanje operacijskog zahvata bilo je 65 minuta, s prosječnim gubitkom krvi od oko 40 ml. Nije bilo većih intraoperativnih ili postoperativnih komplikacija. Prosječno trajanje hospitalizacije bilo je 4 dana. Kod svih bolesnika postoperativno je došlo do potpune ili djelomične korekcije hipertenzije bez pojave lokalnog recidiva. Zaključak: Laparoskopska djelomična adrenalektomija kod aldosteronoma je minimalno invazivna procedura s malom pojavnošću komplikacija. Proceduru je moguće izvesti s dobrim rezultatima kod bolesnika s malim aldosteronomima nabubrežne žlijezde čak i slučajevima zdrave kontralateralne žlijezde.
Databáze: OpenAIRE
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