Feasibility and safety of laparoscopic adrenalectomy for large tumours

Badr Serji; Amine Souadka; Amine Benkabbou; Hajar Hachim; Lamin Jaiteh; Raouf Mohsine; Lahcen Ifrine; Abdelkader Belkouchi; Hadj Omar El Malki

doi:10.1016/j.aju.2016.04.003

Feasibility and safety of laparoscopic adrenalectomy for large tumours

Arab J Urol. 2016 May 19;14(2):143-6. doi: 10.1016/j.aju.2016.04.003. eCollection 2016 Jun.

Authors

Badr Serji¹, Amine Souadka², Amine Benkabbou², Hajar Hachim², Lamin Jaiteh², Raouf Mohsine², Lahcen Ifrine², Abdelkader Belkouchi², Hadj Omar El Malki³

Affiliations

¹ Surgery Department 'A', Ibn Sina Hospital, Medical School, Mohammed V University in Rabat, Morocco; Medical School, Mohammed the First University, Oujda, Morocco.
² Surgery Department 'A', Ibn Sina Hospital, Medical School, Mohammed V University in Rabat, Morocco.
³ Surgery Department 'A', Ibn Sina Hospital, Medical School, Mohammed V University in Rabat, Morocco; Medical Centre of Clinical Trials and Epidemiological Study and Biostatistical, Clinical Research and Epidemiological Laboratory, Medical School, Mohammed V University in Rabat, Morocco; Abulcasis International University of Health Sciences, Abulcasis Medical School, Rabat, Morocco.

Abstract

Objective: To verify the feasibility and safety of laparoscopic adrenalectomy for large tumours, as since it was described, the laparoscopic approach for adrenalectomy has become the 'gold standard' for small tumours and for large and non-malignant adrenal tumours many studies have reported acceptable results.

Patients and methods: This is a retrospective study from a general surgery department from January 2006 to December 2013 including 45 patients (56 laparoscopic adrenalectomies). We divided patients into two groups according to tumour size: <5 or ⩾5 cm, we compared demographic data and peri- and postoperative outcomes.

Results: There was no statistical difference between the two groups for conversion rate (3.7% vs 11.7% P = 0.32), postoperative complications (14% vs 12%, P = 0.4), postoperative length of hospital stay (5 vs 6 days P = 0.43) or mortality (3.5% vs 0% P = 0.99). The only statistical difference was the operating time, at a mean (SD) 155 (60) vs 247 (71) min (P < 0.001).

Conclusion: Laparoscopic adrenalectomy for large tumours needs more time but appears to be safe and feasible when performed by experienced surgeons.

Keywords: ASA, American Society of Anesthesiology; Adrenalectomy; HCC, hepatocellular carcinoma; LA, laparoscopic adrenalectomy; Laparoscopy; Large tumour.