Faculty Collaboration Database

Laparoscopic adrenalectomy for cancer. Semin Surg Oncol 1999 Jun;16(4):293-306

Date

05/20/1999

Pubmed ID

10332775

DOI

10.1002/(sici)1098-2388(199906)16:4<293::aid-ssu4>3.0.co;2-e

Scopus ID

2-s2.0-0344142492 (requires institutional sign-in at Scopus site)   194 Citations

Abstract

We will review the literature on the operative techniques and patient outcomes of laparoscopic adrenalectomy for cancer. Further, in our own study, an analysis of the preoperative assessment, operative, and hospital course, and postoperative follow-up was performed on all patients undergoing a laparoscopic adrenalectomy for cancer or metastasis from October 1996 through February 1998. Twelve laparoscopic resections were performed in 11 patients. There were six males and five females with an average age of 62 years (range, 40 to 79). The mean American Society of Anesthesiologists (ASA) score was 3.1 (range, 2 to 4). All of the tumors except one were due to metastatic cancer. The metastatic sources included renal cell cancer (four), lung cancer (two), colon cancer (two), adrenal cancer (one), and melanoma (one). Seven patients required a left adrenalectomy, three underwent a right adrenalectomy, and one was bilateral. The approach was transperitoneal in eight cases and retroperitoneal in four. The mean size of the tumors was 5.9 cm (range, 1.8 to 12 cm). Operative time averaged 181 minutes (range, 100 to 315 minutes), and blood loss was 138 cc (range, 20 to 1,300 cc). Average hospital stay was 2.3 days (range, < 1 to 6 days). One patient required conversion to an open approach due to local invasion of the tumor into the lateral wall of the vena cava, which was resected with the specimen. This procedure resulted in the largest blood loss of the series (1,300 cc). All specimens had negative surgical margins. There was one complication (9%), a laceration of the epigastric artery, which was controlled laparoscopically. At a mean follow-up of 8.3 months (range, 0.5 to 19 months), there have been no port site or local recurrences. One patient has developed a new hepatic nodule, which is being worked up for metastatic disease. Ten of the 11 patients (91%) are currently alive; one has died of expansive cerebral metastases from melanoma.

Author List

Heniford BT, Arca MJ, Walsh RM, Gill IS

MESH terms used to index this publication - Major topics in bold

Adrenal Gland Neoplasms
Adrenalectomy
Adult
Aged
Female
Humans
Laparoscopy
Male
Middle Aged
Postoperative Care
Prognosis
Treatment Outcome