Laparoscopic adrenalecto my for large adrenal gland neoplas ms near renal hil u m:with a report of 155 cases

Zhu Qingguo; Zhu Wei; Ye Liefu; Hu Minxiong; He Yanyu; Gao Xiangxun

doi:10.3969/j.issn.2095-5146.2015.02.012

Abstract：Objective :To i nvesti gate the surgical techni que of laparoscopic adrenalecto my for large adrenal gland neoplas ms near renal hil u m.Methods :Retrospecti ve anal ysis was conducted with the cli nical data of 1 55 patients with large adrenal gland neoplas ms near renal hil u m fro m Nove mber 2004 to October 201 4 .Operati ons were per-for med with laparoscopic surgery via transperitoneal approach i n 89 cases and via retroperitoneal approach i n the oth-er 66 cases ,i ncl udi ng adrenal adeno mas 43 cases (1 9 cases of hypercortisolis m,6 cases of pri mary al dosteronis m,1 8 cases of nonfuncti oni ng adrenal tu mor ),65 cases of pheochro mocyto ma ,23 cases of adrenal myel oli po ma ,1 6 cases of gangli oneuro ma ,8 cases of adrenocortical carci no ma ,The mean size of tu mors was 7 .5 c m.The operati ve ti me , i ntraoperati ve bl ood l oss ,co mplicati ons ,postoperati ve i ntesti nal recovery and hospital stay were anal yzed .Results :All the operati ons were perfor med successfull y .No one was transferred to open surgery .The mean operati ng ti me and bl ood l oss was 75 mi n and 1 5 mL ,respecti vel y .The mean postoperati ve i ntesti nal recovery and hospital stay was 28 h and 7 d ,respecti vel y .2 cases of postoperati ve subcutaneous e mphyse ma were self-heali ng .Acute adrenocortical i nsufficiency occurred after surgery i n one case which was cured with a large dose of hor mone .Duri ng the foll o w-up of 3 months to 1 0 years ,No tu mor recurrence was found .Conclusions :Both the transperitoneal and retroperitoneal laparoscopic approaches are feasi ble for large adrenal gland neoplas ms near renal hil u m with the advantage of mi ni mal i nvasi on .Which is safe and effecti ve i n well selected and prepared patients by experienced operator .