Open AccessLarge Adrenal Lesion Series in a Tertiary Care Center in Northern India: Diagnostic and Operative Challenges
Author(s) -
Kushagra Gaurav,
Pooja Ramakant,
Shreyamsa Manjunath,
Sasi Mouli,
Kul Ranjan Singh,
Chanchal Rana,
Anand Mishra
Publication year - 2020
Publication title -
indian journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 16
eISSN - 0976-6952
pISSN - 0975-7651
DOI - 10.1007/s13193-020-01114-6
Subject(s) - medicine , surgical oncology , adrenalectomy , perioperative , surgery , multidisciplinary team , retrospective cohort study , general surgery , nursing
Large adrenal tumors pose varied challenges to surgeons in terms of diagnosis, planning surgical approach, and also intra-operative difficulties in resection. The aim of this study is to discuss challenges in the management of large and difficult adrenal lesions. A retrospective analysis was done on data of all patients with large adrenal lesions/paragangliomas managed from 1 June 2016 to 30 August 2018. Forty-eight patients with adrenal lesions underwent treatment in 2 years duration. Pain in the abdomen was the most common presentation. Mean age was 34.4 years (range 2-60), female to male (23:25) and right to left side to bilateral tumor 30:16:2. Thirty-one (64.6%) patients had large adrenal masses (size > 6 cm). Surgical approaches included open transperitoneal adrenalectomy ( n = 20) and laparoscopic transperitoneal ( n = 9 and 2 others had conversion to open procedure). Challenges faced are described in the table below: [Table: see text] There were no major peri-operative morbidities, but two patients died in perioperative period. Large adrenal tumors pose a challenge in surgical planning, approach, and resection and need careful planning and multidisciplinary team approach to have the best outcomes.