Open versus laparoscopic techniques in treatment of adrenal cyst: review of 19 cases

ABSTRACT

To study the effectiveness of laparoscopic management of adrenal cyst disease versus open surgery. Adrenal cysts are rare be benign lesions, mostly asymptomatic and nonfunctioning. Surgery is indicated when the cyst is functioning, the aspirate is haemorrhagic, cyst wall is irregular or if pheochromocytoma is suspected. 19 patients were admitted to Mansoura Urology and Nephrology Centre in Egypt between 1982 and 2005 with adrenal cyst disease and indicated adrenalectomy either surgically or laproscopically. Retrospective study on these cases as regarding the presentation, indication of intervention procedure, pre and postoperative complication and follow up. 10 cases had open adrenalectomy and 9 cases had laparoscopic transperitoneal adrenalectomy. The mean cyst size was 9.5 +/- 3.5 cm in the open technique while it was 8.3 +/- 3.9 in the laparoscopic technique. Hisopathology showed that 10 cases were haemorrhagic pseudocysts and 9 cases were endothelial cysts. The follow up showed that all cases were symptom free postoperatively without radiological evidence of recurrence. Only one case developed postoperative pulmonary infection and fever after laparoscopic adrenalectomy. Haemorrhagic pseudocysts presened 53%, while endothelial cysts presented 47% of cases. 84% of cases presented with ipsilateral upper quadrant abdominal pain. CT scanning succeeded to role out malignancy in 100% of our cases. Laparoscopic adrenalectomy is a safe and effective means of treatment with advantages of less blood loss, more cosmosis and less hospital stay over the open technique