open access

Vol 61, No 1 (2010)
Original papers
Published online: 2010-03-04
Submitted: 2013-02-15
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From open to laparoscopic adrenalectomy: thirty years’ experience of one medical centre

Jerzy Lubikowski, Marek Umiński, Elżbieta Andrysiak-Mamos, Sławomir Pynka, Henryk Fuchs, Maciej Wójcicki, Mikołaj Szajko, Piotr Molęda, Mariola Post, Ewa Żochowska, Bartosz Kiedrowicz, Krzysztof Safranow, Anhelli Syrenicz
Endokrynologia Polska 2010;61(1):94-101.

open access

Vol 61, No 1 (2010)
Original papers
Published online: 2010-03-04
Submitted: 2013-02-15

Abstract


Introduction: Laparoscopic adrenalectomy (LA) has become the standardized treatment of benign adrenal lesions over the last two decades, making the indications to open adrenalectomy (OA) limited. The purpose of this study was to show the thirty years of experience in open (OA) and laparoscopic adrenalectomy (LA) gained in one medical centre as well as to compare the results of OA and LA performed for benign adrenal lesions.
Material and methods: Three hundred patients underwent 127 open and 173 laparoscopic adrenalectomies between 1979 and 2009 at M. Curie Hospital in Szczecin, Poland. Analyzed factors included patients demographic data, ASA score, indication for surgery, tumour size and side, characteristics of the removed tumours, intraoperative and postoperative outcome of LA and OA, postoperative pain sensation, intraoperative and postoperative complications, and conversion rate from LA to OA. Tumours with diameter exceeding 8 cm were excluded.
Results: There were no significant differences regarding the analyzed preoperative data in both groups of patients. The mean operative time was longer in the LA group (137 v. 82 min., p < 0.0001) and the blood loss was lower in LA group (110 v. 254 mL, p < 0.0001). The mean time until resumption of normal diet was shorter after LA (22 v. 44 h), as was the mean time until ambulation (17 v. 36 h), mean length of the hospital stay (4.6 v. 6.8 days), and mean time until return to normal activities (14 v. 23 days, p < 0.0001 for each difference). The analgesic requirement on the first and the second day postoperatively was lower in the LA group (p < 0.0001). The incidence of intraoperative and postoperative complications did not differ significantly between both analyzed groups. The rate of the conversion from LA to OA was 16%. The histopathological diagnosis was adenoma of the adrenal gland in the majority of cases.
Conclusions: This study shows that LA is a safe, effective, and well-tolerated procedure. It may be recommended as a "gold standard" surgery in a case of benign functioning or non-functioning adrenal tumours with diameter less than 8 cm.
(Pol J Endocrinol 2010; 61 (1): 94-101)

Abstract


Introduction: Laparoscopic adrenalectomy (LA) has become the standardized treatment of benign adrenal lesions over the last two decades, making the indications to open adrenalectomy (OA) limited. The purpose of this study was to show the thirty years of experience in open (OA) and laparoscopic adrenalectomy (LA) gained in one medical centre as well as to compare the results of OA and LA performed for benign adrenal lesions.
Material and methods: Three hundred patients underwent 127 open and 173 laparoscopic adrenalectomies between 1979 and 2009 at M. Curie Hospital in Szczecin, Poland. Analyzed factors included patients demographic data, ASA score, indication for surgery, tumour size and side, characteristics of the removed tumours, intraoperative and postoperative outcome of LA and OA, postoperative pain sensation, intraoperative and postoperative complications, and conversion rate from LA to OA. Tumours with diameter exceeding 8 cm were excluded.
Results: There were no significant differences regarding the analyzed preoperative data in both groups of patients. The mean operative time was longer in the LA group (137 v. 82 min., p < 0.0001) and the blood loss was lower in LA group (110 v. 254 mL, p < 0.0001). The mean time until resumption of normal diet was shorter after LA (22 v. 44 h), as was the mean time until ambulation (17 v. 36 h), mean length of the hospital stay (4.6 v. 6.8 days), and mean time until return to normal activities (14 v. 23 days, p < 0.0001 for each difference). The analgesic requirement on the first and the second day postoperatively was lower in the LA group (p < 0.0001). The incidence of intraoperative and postoperative complications did not differ significantly between both analyzed groups. The rate of the conversion from LA to OA was 16%. The histopathological diagnosis was adenoma of the adrenal gland in the majority of cases.
Conclusions: This study shows that LA is a safe, effective, and well-tolerated procedure. It may be recommended as a "gold standard" surgery in a case of benign functioning or non-functioning adrenal tumours with diameter less than 8 cm.
(Pol J Endocrinol 2010; 61 (1): 94-101)
Get Citation

Keywords

adrenal tumour; laparoscopic adrenalectomy; open adrenalectomy

About this article
Title

From open to laparoscopic adrenalectomy: thirty years’ experience of one medical centre

Journal

Endokrynologia Polska

Issue

Vol 61, No 1 (2010)

Pages

94-101

Published online

2010-03-04

Bibliographic record

Endokrynologia Polska 2010;61(1):94-101.

Keywords

adrenal tumour
laparoscopic adrenalectomy
open adrenalectomy

Authors

Jerzy Lubikowski
Marek Umiński
Elżbieta Andrysiak-Mamos
Sławomir Pynka
Henryk Fuchs
Maciej Wójcicki
Mikołaj Szajko
Piotr Molęda
Mariola Post
Ewa Żochowska
Bartosz Kiedrowicz
Krzysztof Safranow
Anhelli Syrenicz

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