LAPAROSCOPIC ADRENALECTOMY FOR BIG ADRENAL TUMORS markogiannakis@yahoo.com

PW06-06

LAPAROSCOPIC ADRENALECTOMY FOR BIG ADRENAL TUMORS

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Greece

Oral or Poster

Our aim was to analyze the results of laparoscopic adrenalectomy for big adrenal tumors.

Prospective study of all unilateral laparoscopic adrenalectomies during the period 2010-2024. Patients having tumor ≥7cm were compared with those with tumor <7cm. Data analyzed were: sex, age, previous abdominal operation, left/right location, final diagnosis, operative and anesthesia time, conversion to open surgery, intraoperative and postoperative complications, postoperative hospital stay and final outcome.

A total of 141 cases (women:64.5%, age:53.8±9.4years) were included. Diagnosis was: non-functioning adenoma in 34.8%, ACTH-independent Cushing’s syndrome 17%, pheochromocytoma 14.9%, Conn’s syndrome 12.1%, metastasis 6.4%, myelolipoma 3.5%, lipoma 1.4%, carcinoma 1.4% and other 8.5%. Tumor diameter was 5.2±1.8cm (1.2-10cm). Twenty-seven patients (19.2%) had tumor ≥7cm (group A) while 114 (80.8%) tumor <7cm (group Β). Women composed 51.8% of group A and 67.5% of group B (p>0.05). Intraoperative complications were more often reported in group A than group Β (7.4% vs. 2.6%, p<0.05). Conversion was required in 4 group Α (14.8%) while in 7 of group Β (6.1%) cases (p<0.05). Operative and anesthesia time in group A was 115±18.6min and 145.8±20.3min whereas in group Β 90±14.2min and 119.6±17.4min respectively (p<0.05). Postoperative complications were observed in 3 group A (11.1%) and 9 group Β (7.9%) cases (p>0.05). Postoperative stay was longer in group A (3.4±0.7 vs. 2.5±0.5 days, p<0.05). No other significant differences were noticed.

Laparoscopic adrenalectomy in big tumors is safe and effective but may more often encounter intraoperative complications and requires prolonged operative and anesthesia time, longer postoperative stay and higher conversion rate.