• 作者：Cé ; sar P. Ram&#237 ; rez-Plaza^a ; ^{cprptot@hotmail.com} ; Alberto Rodr&#237 ; guez-Cañ ; ete^a ; Marta E. Dom&#237 ; nguez-Ló ; pez^b ; Marta Valle-Carbajo^a ; Carolina Jimé ; nez-Mazure^a ; Naiara Mar&#237 ; n-Camero^a ; José ; L. Gallego-Perales^a ; Julio Santoyo-Santoyo^a
• 关键词：Suprarrenalectomí ; a ; Ví ; a laparoscó ; pica ; Tumor adrenal
• 刊名：Endocrinolog铆a y Nutrici贸n
• 出版年：2010
• 期刊代码：pca151_15750922
• 类别：med
• 出版时间：January 2010
• 卷：57
• 期：1
• 页码：22-27
• 文件大小：333 K

Background

After the first reports in 1992, laparoscopic adrenalectomy (LA) has evolved technically until becoming the standard approach for the treatment of most of the adrenal gland diseases.

Material y methods

Retrospective and descriptive study of 67 patients who underwent 68 LA between January-1998 and December-2008 in the Laparoscopic Surgery Unit of the General and Digestive Surgery Service in a third level hospital (only one case of bilateral LA). The group was divided in 2 periods, P-1 (1998-2003, 22 cases) and P-2 (2004-2008, 45 cases), which have been compared to evaluate the evolution of the LA technique.

Results

Indications for LA were: 19 incidentalomas, 19 primary hyperaldosteronism, 18 pheocromocitoms, 5 cases of symptomatic and non-functioning adrenal masses, 4 Cushing adenomas and 2 metastases. There was no mortality, only 4 patients had minor complications (6%) and conversion rate was only 3%(2 cases). Mean size of adrenal glands resected was 3,83 cm and the mean operative time was 86 minutes. Mean postoperative hospital stay was 3 days and in P-2 seventeen patients were discharged on an outpatient basis (hospital stay less than 23 hours).

Conclusions

in our experience, LA for the treatment of adrenal diseases has shown to be safe, effective and reproducible with low complications and excellent tolerance by patients. When the learning curve is overcome, hospital stay and operative time clearly decrease. As a consequence, LA can be planned in selected cases as outpatient surgery with good results.