Premium
ES20P
THE SURGICAL APPROACH TO THE ADRENAL GLAND – THE CHANGING PRACTICE
Author(s) -
Rohana A.,
Hisham A. N.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04118_20.x
Subject(s) - medicine , adrenalectomy , perioperative , malignancy , adrenal gland , surgery , group b , laparoscopy
Adrenal surgery in our institution has evolved from open surgery to laparoscopic approach. The aim of this paper was to evaluate the feasibility and changes in the practice of adrenal surgery. Methods A total of 129 consecutive patients who had adrenal surgery from October 1998 to 2006 were included in this study. The patient’s demographic data, clinical manifestation, tumour characteristics and duration of hospitalization were reviewed. The main outcome measures were operation time and perioperative complications. Results There were 77(59.7%) women and 52(40.3%) men with the mean age of 41.5 years (ranged 13 to 88 years old). All our patients were closely evaluated and monitored by endocrinologist. CT scan or MRI was routinely used to localize the adrenal lesions. 67(51.9%) patients had open transabdominal adrenalectomy (Group 1), 22(17.1%) patients had open posterior approach (Group 2) and 40(31.0%) patients had laparoscopic adrenalectomy (Group 3). The mean weight of the tumour in Group 1 was 312 grams (ranged10 to 1800 grams), Group 2 was 20 grams (ranged 5 to 200 grams) and Group 3 was 20 grams (ranged 10 to 70 grams). The average hospitalization for Group 1 was 6.5 days (ranged 3 to 14 days), Group 2 was 4.5 days (ranged 4 to 6 days) and Group 3 was 3.3 days (ranged 2 to 8 days). Conclusions Laparoscopic adrenalectomy is today the treatment of choice for most small benign adrenal tumour. Nonetheless in larger adrenal lesions and in adrenal malignancy open transabdominal adrenalectomy inevitably may still be the desired approach.