A Clinical Review of Initial 20 Cases of Laparoscopic Adrenalectomy / 대한내분비외과학회지

PURPOSE: The laparoscopic adrenalectomy (LA) has become the preferred procedure for adrenal tumors due to many advantages; a more rapid and comfortable recovery, shortened hospitalization period, and fewer complications. This study reports on an initial 4 year period of experience with LA and describes various unusual findings encountered during the treatment. METHODS: From February 1997 to November 2000, a total of 20 LA were performed. Of the several LA techniques previously described we prefer the transabdominal approach in the lateral decubitus position utilizing 3 or 4 trocars, and this method was employed in all the cases presented here. RESULTS: All 20 patients had a unilateral tumor. The pathological findings consisted of 11 aldosteronomas, 6 Cushing adenomas, 2 pheochromocytomas and 1 cortical carcinoma. Of the 20 patients, 18 were successfully operated with the laparoscopic procedure and the remaining 2 cases were converted to open adrenalectomy. The reasons for conversion were sudden cardiac arrest of unknown origin in one and intraoperative bleeding due to periadrenal massive fat in the other. During LA, 2 patients with non-catecholaminesecreting cortical adenomas pathologies displayed abnormal EKG findings, which reverted to normal after the operation. The average complete LA operation times was 186 minutes in the first 9 cases and 132 minutes in the next 9 cases. The first oral intake was started within 24 hours in all cases. There were no postoperative complications, operative morbidity or mortality. The average hospital stay was 6.2 days in the first 9 cases and 4.2 days in the next 9 cases. CONCLUSION: LA is a relatively fast and safe method and has become is accepted as the preferred procedure for adrenal tumors but it requires good perioperative preparation. Surgeons and anesthesiologists need to be aware of the possible cardiovascular complications and of the problems inherent in the manipulation of the adrenal gland during LA.

A Clinical Review of Initial 20 Cases of Laparoscopic Adrenalectomy / 대한내분비외과학회지

PURPOSE: The laparoscopic adrenalectomy (LA) has become the preferred procedure for adrenal tumors due to many advantages; a more rapid and comfortable recovery, shortened hospitalization period, and fewer complications. This study reports on an initial 4 year period of experience with LA and describes various unusual findings encountered during the treatment. METHODS: From February 1997 to November 2000, a total of 20 LA were performed. Of the several LA techniques previously described we prefer the transabdominal approach in the lateral decubitus position utilizing 3 or 4 trocars, and this method was employed in all the cases presented here. RESULTS: All 20 patients had a unilateral tumor. The pathological findings consisted of 11 aldosteronomas, 6 Cushing adenomas, 2 pheochromocytomas and 1 cortical carcinoma. Of the 20 patients, 18 were successfully operated with the laparoscopic procedure and the remaining 2 cases were converted to open adrenalectomy. The reasons for conversion were sudden cardiac arrest of unknown origin in one and intraoperative bleeding due to periadrenal massive fat in the other. During LA, 2 patients with non-catecholaminesecreting cortical adenomas pathologies displayed abnormal EKG findings, which reverted to normal after the operation. The average complete LA operation times was 186 minutes in the first 9 cases and 132 minutes in the next 9 cases. The first oral intake was started within 24 hours in all cases. There were no postoperative complications, operative morbidity or mortality. The average hospital stay was 6.2 days in the first 9 cases and 4.2 days in the next 9 cases. CONCLUSION: LA is a relatively fast and safe method and has become is accepted as the preferred procedure for adrenal tumors but it requires good perioperative preparation. Surgeons and anesthesiologists need to be aware of the possible cardiovascular complications and of the problems inherent in the manipulation of the adrenal gland during LA.

A Clinical Review of Initial 20 Cases of a Laparoscopic Adrenalectomy / 대한내분비외과학회지

PURPOSE: The laparoscopic adrenalectomy (LA) has become the preferred procedure for adrenal tumors since it has many advantages; a more rapid and comfortable recovery, shorted hospitalization, and fewer complications. The purpose of this study was to report the initial 4 years experiences of LA and describe the unusual findings encountered during the operations. METHODS: From February 1997 to November 2000, a total of 20 LA were performed. Several techniques of LA have been described already. We prefer the transabdominal approach in the lateral decubitus position using 3 or 4 trocars. RESULTS: 20 patients had all unilateral tumor. The pathological findings were 11 aldosteronomas, 6 Cushing adenomas, 2 pheochromocytomas and 1 cortical carcinoma. 18 cases of 20 patients were successfully operated by laparoscopic procedure and 2 cases were converted to open adrenalectomy. The reasons of conversion were sudden cardiac arrest due to unknown origin and intraoperative bleeding due to periadrenal massive fat. During the laparoscopic operation, 2 patients showed abnormal EKG findings. The pathologies of those patients were non-catecholamine-secreting cortical adenomas. After operation, they have been completely normal in EKG. The average operating time for the complete laparoscopic adrenalectomies was 186 minutes in the first 9 cases and 132 minutes in the next 9 cases. The first oral intake was started within 24 hours in all cases. There was no postoperative complication and no operative morbidity or mortality. The average hospital stay was 6.2 days in the first 9 cases and 4.2 days in the next 9 cases. CONCLUSION: The LA is relatively fast and safe method and is accepted as the preferred procedure for the adrenal tumors but it should be well prepared perioperatively. Surgeons and anesthesiologists should be aware of those possible cardiovascular complications and of the problems inherent in the manipulation of the adrenal gland during LA.

A Clinical Review of 20 Initial Cases of Laparoscopic Adrenalectomy

PURPOSE: The laparoscopic adrenalectomy (LA) has become the preferred procedure for adrenal tumors due to many advantages; a more rapid and comfortable recovery, shortened hospitalization period, and fewer complications. This study reports on an initial 4 year period of experience with LA and describes various unusual findings encountered during the treatment. METHODS: From February 1997 to November 2000, a total of 20 LA were performed. Of the several LA techniques previously described we prefer the transabdominal approach in the lateral decubitus position utilizing 3 or 4 trocars, and this method was employed in all the cases presented here. RESULTS: All 20 patients had a unilateral tumor. The pathological findings consisted of 11 aldosteronomas, 6 Cushing adenomas, 2 pheochromocytomas and 1 cortical carcinoma. Of the 20 patients, 18 were successfully operated with the laparoscopic procedure and the remaining 2 cases were converted to open adrenalectomy. The reasons for conversion were sudden cardiac arrest of unknown origin in one and intraoperative bleeding due to periadrenal massive fat in the other. During LA, 2 patients with non-catecholamine-secreting cortical adenomas pathologies displayed abnormal EKG findings, which reverted to normal after the operation. The average complete LA operation times was 186 minutes in the first 9 cases and 132 minutes in the next 9 cases. The first oral intake was started within 24 hours in all cases. There were no postoperative complications, operative morbidity or mortality. The average hospital stay was 6.2 days in the first 9 cases and 4.2 days in the next 9 cases. CONCLUSION: LA is a relatively fast and safe method and has become is accepted as the preferred procedure for adrenal tumors but it requires good perioperative preparation. Surgeons and anesthesiologists need to be aware of the possible cardiovascular complications and of the problems inherent in the manipulation of the adrenal gland during LA.