SINGLE CENTER EXPERIENCE WITH LAPAROSCOPIC ADRENALECTOMY AND OPEN SURGERY ON A PREOPERATIVE DIAGNOSIS OF ADRENAL HEMORRHAGE siavashfeiz@gmail.com

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SINGLE CENTER EXPERIENCE WITH LAPAROSCOPIC ADRENALECTOMY AND OPEN SURGERY ON A PREOPERATIVE DIAGNOSIS OF ADRENAL HEMORRHAGE

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Poland

Oral or Poster

Laparoscopy has become the procedure of choice for treating benign functioning and non-functioning adrenal tumors. It is the gold-standard technique for small and medium-sized benign adrenal masses (<6 cm). Open surgery remains the first choice for adrenal cancer, especially in cases where surrounding tissues are involved or for tumors larger than 6 cm.

Between 2012 and 2022, a total of 649 adrenalectomies were performed, 39 of which were due to adrenal hemorrhage (AH) detected in emergency rooms in a Polish hospital and finally admitted for diagnosis and treatment to the Department of Internal Medicine and Endocrinology or Department of General, Endocrine and Vascular Surgery.

The patient group was an average age of approximately 56 years. The mean size of adrenal tumors was 71.9 mm, and more than half of the patients had tumors larger than 60 mm. The most common tumor type was pheochromocytoma (28.2%, n=11), followed by adrenal adenoma (23.1%, n=9), adrenocortical carcinoma (10.3%, n=4), and adrenal metastases (7.7%, n=3). Approximately 53% of the surgeries involved the left adrenal gland, and nearly 80% were performed laparoscopically.

Although laparoscopic techniques have become a routine part of daily surgical practice, it is important not to overlook the value of traditional open surgical approaches. As demonstrated by our experience, almost any tumor can be safely removed laparoscopically if it meets the appropriate criteria. However, in hemorrhaging tumors where the capsule has ruptured, laparoscopic surgery is dangerous for the patient. Open surgery should be chosen in these cases.