Retroperitoneoscopic adrenalectomy with dorsal approach
Authors:
P. Zonca 1,2; M. Cambal 1,2; P. Labaš 2; C. A. Jacobi 1
Authors‘ workplace:
Zentrum für Viszeral und Minimal Invasive Chirurgie, Wesseling, Köln am Rhein, Německo, přednosta: Prof. Dr. med. C. A. Jacobi, Ph. D.
1; 1. Chirurgická klinika, Bratislava, přednosta: Prof. MUDr. Peter Labaš, CSc.
2
Published in:
Rozhl. Chir., 2012, roč. 91, č. 4, s. 235-240.
Category:
Original articles
Overview
Introdustion:
Various surgical mininvasive approaches for adrenalectomy have been established over the last two decades. We are evaluating the retroperitoneoscopic adrenalectomy with dorsal approach.
Material and methods:
The prospective open clinical trial was carried out to evaluate intra-operative (operations time, intraoperative complications, blood loss, conversion rate) and peri-operative parameters (morbidity, mortality, hospital stay). Patients who underwent retroperitoneoscopic adrenalectomy with dorsal approach were included in the trial. A tumor size above 12 cm or BMI higher than 35kg/m2 were considered asexclusion criteria. All the patients were perioperatively managed by a multidisciplinary team.
Results:
A total of 81 patients were assessed (average age: 45.7 yrs, 37 males, 44 females, BMI 27.8 kg/m2). The average operating time was 61 minutes. The intraoperative blood loss was below 20 ml. The mean hospital stay was 2.1 days. Morbidity was 2.7% and mortality 0%.
Conclusion:
Retroperitoneoscopic adrenalectomy with dorsal approach is considered a method of choice in our hospital. The use of this approach is safe, efficient, with excellent reproducible operative results and impressive patient recovery.
Key words:
adrenalectomy – retroperitoneoscopic – dorsal
Sources
1. Snow LL. Endoscopic general surgery: an uptodate, Laser Highlights 1991;2:1–3.
2. Gagner M, Lacroix A, Bolte E. Laparoscopic adrenalectomy in Cushingęs syndrome and pheochromocytom. N Engl J Med 1992;327:1033.
3. Gagner M, Lacroix A, Prinz RA, Bolte E, Albala D, Polvin C. Early experience with laparoscopic approach for adrenalectomy. Surgery 1993;114:1120–1125.
4. Kasalický M, Krsek M, Zelinka T, Hána V, Widimský J. 120 laparoscopic adrenalectomies with a harmonic scalpel. Rozhl Chir 2009;88:439–443.
5. Stránský P, Hora M, Eret V, Klecka J, Urge T, Grégrová H, Dvoráková E, Hes O, Chudácek Z, Kreuzberg B. Laparoscopic adrenalectomy. Rozhl Chir 2009;88:514–520.
6. Safarík L, Vraný M, Widimský J, Dvorácek J, Novák K, Dusková J. Laparoscopic transperitoneal adrenalectomy in hormonally-active adrenal tumors. Rozhl Chir 2002;81(3):127–132.
7. Mandressi A, Buizza C, Antonelli D, Chisena S, Servadio G. Retroperitoneoscopy. Ann Urol (Paris) 1995;29:91–96.
8. Mercan S, Seven R, Ozarmagan S. Endoscopic retroperitoneal adrenalectomy. Surgery 1995;118:1071–1075.
9. Walz MK, Peitgen K, Krause U, Eigler FW. Die dorsale Adrenalektomie – eine operative Technik, Zentralbl Chir 1995:53–58.
10. Walz MK, Peitgen K, Walz MV, Hoermann R, Saller B, Gibler RM, Jockenhövel F, Philipp T, Broelsch CE, Eigler FW, Mann K. Posterior retroperitoneoscopic adrenalectomy: lessons learned within five years. World J Surg 2001;25:728–734.
11. Perrier ND, Kennamer DL, Bao R, Jimenez C, Grubbs EG, Lee JE, Evans DB. Posterior retroperitoneoscopic adrenalectomy: preferred technique for removal of benign tumors and isolated metastases. Ann Surg 2008;248:666–674.
12. Thomson GB, Grant CS. Van Heerden JA, Schlinkert RT, Young WF, Farley DR, Ilstrup DM. Laparoscopic versus open posterior adrenalectomy: a case-control study of 100 patients. Surgery 1997;122:1132–1136.
13. Imai T, Kikumori T, Ohiwa M, Mase T, Funahashi H. A case-controlled study of laparoscopic compared with open lateral adrenalectomy. M J Surg 1999;178:50–53.
14. Smith CD, Weber CJ, Amerson JR. Laparoscopic adrenlectomy: new gold standard. World J Surg 1999;23:389–396.
15. Takeda M, Go H, Watanabe R, Kurumada S, Obara K, Takahashi E, Komeyama T, Imai T, Takahashi K. Retroperitoneal laparoscopic adrenalectomy for functioning adrenal tumors: comparison with conventional transperitoneal laparoscopic adrenalectomy. J Urol 1997;157:19–23.
16. Naya Y, Nagata M, Ichikawa T, Amakasu M, Omura M, Nishikawa T, Yamaguchi K, Ito H. Laparoscopic adrenalectomy: comparison of transperitoneal and retroperitoneal approaches. BJU Int 2002;90:199–204.
17. Dickson PV, Jimenez C, Chisholm GB, Kennamer DL, Ng C, Grubbs EG, Evans DB, Lee JE, Perrier ND. Posterior retroperitoneoscopic adrenalectomy: a contemporary American experience. J Am Coll Surg 2011;212(4):659–65, discussion 665–7.
18. Agha A, von Breitenbuch P, Gahli N, Piso P, Schlitt HJ. Retroperitoneoscopic Adrenalectomy: Lateral versus dorsal Approach, JSO 2008;97:90–93.
19. Giebler RM, Walz MK, Peitgen K, Scherer RU. Hemodynamic changes after retroperitoneal CO2 insufflation for posterior retroperitoneoscopic adrenalectomy. Anest Analg 1996;82:827–831.
20. Walz MK, Alesina PF, Wenger FA, Deligiannis A, Szuczik E, Petersenn S, Ommer A, Groeben H, Peitgen K, Janssen OE, Philipp T, Neumann HP, Schmid KW, Mann K. Posterior retroperitoneoscopic adrenalectomy-results of 560 procedures in 520 patients. Surgery 2006;140(6):943–8;discussion 948–50.
21. Karabulut K, Agcaoglu O, Aliyev S, Siperstein A, Berber E. Comparison of intraoperative time use and perioperative outcomes for robotic versus laparoscopic adrenalectomy. Surgery 2011 Dec 3. [Epub ahead of print].
22. Walz MK, Groeben H, Alesina PF. Single-access retroperitoneoscopic adrenalectomy (SARA) versus conventional retroperitoneoscopic adrenalectomy (CORA): a case-control study. World J Surg 2010;34(6):1386–90.
23. Sturgeon C, Kebebew E. Laparoscopic adrenalectomy for malignancy. Surg Clin North Am 2004;84(3):755–774.
24. Kebebew E, et al. Results of laparoscopic adrenalectomy for suspected and unsuspected malignit adrenal neoplasms. Arch Surg 2002;137(8):948–951;discussion 952–953.
25. Lezoche E, Guerrieri M, Crosta F, et al. Perioperative results of 214laparoscopic adrenalectomies by anterior transperitoneal approach.Surg Endosc 2008;22:522–526.
26. Henry JF, Defechereux T, Raffaelli M, et al. Complications of laparoscopic adrenalectomy: results of 169consecutive procedures. World J Surg 2000;24:1342–1346.
27. Zhang X, Fu B, Lang B, et al. Technique of anatomical retroperitoneoscopic adrenalectomy with report of 800cases. J Urol 2007;177:1254–1257.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2012 Issue 4
Most read in this issue
- GIST: Current knowledge and treatment modalities
- Laparoscopic adrenalectomy – indications and selection criteria
- Prevention of parastomal hernia using laparoscopic introduction of a prosthetic mesh – initial experience
- Extragastrointestinal stromal tumor (EGIST)