Retroperitoneal Laparoscopic Adrenalecto my for selected adrenal tumors >6 cm:our technique and experience

Huang Hai; RenJizhong; Huang Yi; Gao Yi; Cui Xingang; Yao Yacheng; Xu Danfeng

Abstract：Objective:To evaluate the feasibility of retroperitoneal laparoscopic adrenalectomy for large (>6 cm in diameter )adrenal tumors .Methods:A retrospective review was carried out on 98 patients with large adrenal tumors who underwent retroperitoneal laparoscopic adrenalectomy in our hospital between June 2002 to June 2013 . With the patients being placed in the lateral position at the uninjured side ,a self-made balloon was used to dilate the retroperitonealspace.Afterwards,3trocars wereinsertedviathecostal marginattheposterioraxillarylineandthe anterior axillary line ,and 2 cm above the anterior superior iliac spine at the middle axillary line to re move the tumors.Afterresectionofthetumor,andrainagetube wasindwelled.Results:The meandiameterofthetumors was (8.1 ±3.2 )cm (range ,6.5 to 12.6 cm).Retroperitoneal laparoscopic surgery was perfor med successfully on 96 ca-ses,and 2 cases were converted to opensurgery in the earlier period of our experience.The mean operation time was 65 min (range ,45 to 135 min),and the mean blood loss was 80 mL (range ,50 to 700 mL).Over a mean of l8.5-month follow-up (range ,3 to 36 months )was achieved in the cases ,during which 87 cases had no local recurrence . Nine cases died ,of which 7 were cancer related .Conclusions:When perfor med by experienced surgeons ,retroperito-neal laparosoopie adrenalectomyis feasible and safe for patients withlarge adrenal tumors (>8 cm)as long as no contraindication of the surgery is found .