- 作者：Roberto Iglesias Lopes ; Francisco Tibor D¨¦nes ; J¨²lio Bissoli ; Berenice Bilharino Mendonca ; Miguel Srougi
- 关键词：Adrenal glands ; Laparoscopy ; Children ; Adrenalectomy ; Surgical procedures ; Minimally invasive
- 刊名：Journal of Pediatric Urology
- 出版年：2012
- 出版时间：August, 2012
- 年：2012
- 卷：8
- 期：4
- 页码：379-385
- 全文大小：792 K
Purpose
Reporting on the laparoscopic technique for adrenal disease in children and adolescents has been limited. We review here our experience with laparoscopic adrenal surgery in children.Patients and methods
19 laparoscopic unilateral adrenalectomies were performed in 10 girls and 7 boys (mean age 3.9 years) during 1998-2011. The clinical diagnosis before surgery was virilizing tumor (n?=?8), pheochromocytoma (n?=?3), nonfunctioning solid adrenal tumor (n?=?3), mixed adrenocortical tumor (n?=?2), cystic adrenal mass (n?=?1). Unilateral adrenal lesions were 20-65?mm at the longest axis on computerized tomography (12 right side, 7 left side).
Results
The final clinicopathological diagnosis was cortical adenoma (n?=?9), pheochromocytoma (n?=?3, bilateral in two), neuroblastoma (n?=?1), ganglioneuroblastoma (n?=?1), ganglioneuroma (n?=?1), adrenocortical carcinoma (n?=?1), benign adrenal tissue (n?=?1). Average operative time was 138.5?min (range 95-270). Blood transfusion was required in one case (5 % ). No conversion to open surgery was required and no deaths or postoperative complications occurred. Average hospital stay was 3.5 days (range 2-15). Average postoperative follow-up was 81 months (range 2-144). Two contralateral metachronic pheochromocytomas associated with von Hippel-Lindau syndrome occurred, treated with partial laparoscopic adrenalectomy (one without postoperative need of cortisone replacement therapy).
Conclusions
Laparoscopic adrenalectomy is a feasible procedure that produces good results. It can be used safely to treat suspected benign and malignant adrenal masses in children with minimal morbidity and short hospital stay.