Surrenalectomie par abord coelioscopique : experience du Centre Hospitalier de Chambery (France) a propos de 12 cas

ABSTRACT

Objective: Laparoscopic adrenalectomy has reduced the morbidity rate associated with the classical approaches. The authors herein evaluate their experience with this technique at the hospital of Chambery; France. Patients and Methods: The files of all patients subjected to laparoscopic adrenalectomy at the department of General and Thoracic Surgery between 1996 and 2000 were reviewed. A partial lateral decubitus flank approach at 45o was used. Results: The study included 12 patients; 8 of them were females and 4 males. The mean patient age was 45 years ranging from 26 to 69 years. The adrenal gland diseases encountered were Conn adenoma in 4; Cushing's syndrome in 3 (with one case of Cushing's disease); pheochromocytoma in 3 and incidentaloma in 2 cases. The mean tumor size was 5.5 cm (range 1.8 to 9 cm). The operative time ranged from 70 to 135 minutes for unilateral adrenalectomy and it was 322 minutes for bilateral adrenalectomy including the time needed for changing sides and repositioning. Only one patient (8.3) required laparotomy because of uncontrollable bleeding and hemodynamic instability. The mean hospital stay was 5.4 days (range 4 to 9 days) for unilateral adrenalectomy. Due to hormonal treatment; the mean hospital stay for patients subjected to bilateral adrenalectomy was 13 days. One patient (8.3) developed hematoma at the side of adrenalectomy and was treated with antibiotics and anti-inflammatory drugs. No mortality was encountered. Conclusion: This small series has shown that laparoscopic adrenalectomy is a very promising technique which can be recommended for tumors up to the size of 9 cm