LAPAROSCOPIC TRANSPERITONEAL ADRENALECTOMY- OUTCOMES AFTER RESECTION OF INCREASED SIZE- AND MALIGNANT LESIONS
EAES Academy. Ottlakan A. 07/05/22; 363149; P194
Dr. Aurel Ottlakan
Contributions
Contributions
Abstract
Aims The analysis of operative- and perioperative outcomes for lesions with increased size- and malignancy, in cases of laparoscopic transperitoneal (TP) adrenalectomy.
Methods Data of 135 patients undergoing laparoscopic TP adrenalectomy during a 20 year period has been analyzed. Both operative- (intraoperative blood loss, previous abdominal surgery, conversion rate, operative time, tumor size) and perioperative parameters [body mass index (BMI), American Society of Anesthesiologists (ASA) score, hospital stay, histology) were analyzed for malignant, large (LA) (6-10 cm) and extra-large (ELA) (10 cm<) lesions.
Results Out of a total 135 procedures, 18 malignant lesions (13,33%) were removed during TP adrenalectomy (11 metastasis, 6 adrenocortical carcinoma, 1 leiomyosarcoma). Complete, R0 resection was carried out in each case. Mean size of malignant lesions was 79.94 mm, previous abdominal surgery occurred in 77.77%, conversion was needed in 11.11%, mean intraoperative blood loss was 59.16 ml, mean hospital stay was 5.8 days, with mean operative time of 85.5 minutes. Among the 47 increased size lesions (LA: 40 vs ELA: 7), mean tumor size was 71.85 and 141.57 mm, rate of previous abdominal surgery 12 (30%) vs 5 (71.42%), mean intraoperative blood loss 64.47 ml vs 71.85 ml, hospital stay 5.10 vs 4.57 days, mean operative time 76.52 vs 79.28 minutes, mean BMI 23.45 vs 27.87, and mean ASA score 2.62 vs 2.42 for LA and ELA lesions, respectively. In terms of malignant lesions, 1 adrenocortical carcinoma and 4 metastases occurred in the LA-, and 3 adrenocortical carcinomas in the ELA group. Three ELA lesions (2 adrenocortical carcinomas and 1 neurofibroma) were removed through an additional mini-Pfannenstiel incision.
Conclusion Transperitoneal laparoscopic adrenalectomy proves to be a safe and feasible method in the removal of large-, extra-large-, and even malignant lesions. During the resection of malignant lesions, oncological radicality with complete resection is to be considered a priority.
Methods Data of 135 patients undergoing laparoscopic TP adrenalectomy during a 20 year period has been analyzed. Both operative- (intraoperative blood loss, previous abdominal surgery, conversion rate, operative time, tumor size) and perioperative parameters [body mass index (BMI), American Society of Anesthesiologists (ASA) score, hospital stay, histology) were analyzed for malignant, large (LA) (6-10 cm) and extra-large (ELA) (10 cm<) lesions.
Results Out of a total 135 procedures, 18 malignant lesions (13,33%) were removed during TP adrenalectomy (11 metastasis, 6 adrenocortical carcinoma, 1 leiomyosarcoma). Complete, R0 resection was carried out in each case. Mean size of malignant lesions was 79.94 mm, previous abdominal surgery occurred in 77.77%, conversion was needed in 11.11%, mean intraoperative blood loss was 59.16 ml, mean hospital stay was 5.8 days, with mean operative time of 85.5 minutes. Among the 47 increased size lesions (LA: 40 vs ELA: 7), mean tumor size was 71.85 and 141.57 mm, rate of previous abdominal surgery 12 (30%) vs 5 (71.42%), mean intraoperative blood loss 64.47 ml vs 71.85 ml, hospital stay 5.10 vs 4.57 days, mean operative time 76.52 vs 79.28 minutes, mean BMI 23.45 vs 27.87, and mean ASA score 2.62 vs 2.42 for LA and ELA lesions, respectively. In terms of malignant lesions, 1 adrenocortical carcinoma and 4 metastases occurred in the LA-, and 3 adrenocortical carcinomas in the ELA group. Three ELA lesions (2 adrenocortical carcinomas and 1 neurofibroma) were removed through an additional mini-Pfannenstiel incision.
Conclusion Transperitoneal laparoscopic adrenalectomy proves to be a safe and feasible method in the removal of large-, extra-large-, and even malignant lesions. During the resection of malignant lesions, oncological radicality with complete resection is to be considered a priority.
Aims The analysis of operative- and perioperative outcomes for lesions with increased size- and malignancy, in cases of laparoscopic transperitoneal (TP) adrenalectomy.
Methods Data of 135 patients undergoing laparoscopic TP adrenalectomy during a 20 year period has been analyzed. Both operative- (intraoperative blood loss, previous abdominal surgery, conversion rate, operative time, tumor size) and perioperative parameters [body mass index (BMI), American Society of Anesthesiologists (ASA) score, hospital stay, histology) were analyzed for malignant, large (LA) (6-10 cm) and extra-large (ELA) (10 cm<) lesions.
Results Out of a total 135 procedures, 18 malignant lesions (13,33%) were removed during TP adrenalectomy (11 metastasis, 6 adrenocortical carcinoma, 1 leiomyosarcoma). Complete, R0 resection was carried out in each case. Mean size of malignant lesions was 79.94 mm, previous abdominal surgery occurred in 77.77%, conversion was needed in 11.11%, mean intraoperative blood loss was 59.16 ml, mean hospital stay was 5.8 days, with mean operative time of 85.5 minutes. Among the 47 increased size lesions (LA: 40 vs ELA: 7), mean tumor size was 71.85 and 141.57 mm, rate of previous abdominal surgery 12 (30%) vs 5 (71.42%), mean intraoperative blood loss 64.47 ml vs 71.85 ml, hospital stay 5.10 vs 4.57 days, mean operative time 76.52 vs 79.28 minutes, mean BMI 23.45 vs 27.87, and mean ASA score 2.62 vs 2.42 for LA and ELA lesions, respectively. In terms of malignant lesions, 1 adrenocortical carcinoma and 4 metastases occurred in the LA-, and 3 adrenocortical carcinomas in the ELA group. Three ELA lesions (2 adrenocortical carcinomas and 1 neurofibroma) were removed through an additional mini-Pfannenstiel incision.
Conclusion Transperitoneal laparoscopic adrenalectomy proves to be a safe and feasible method in the removal of large-, extra-large-, and even malignant lesions. During the resection of malignant lesions, oncological radicality with complete resection is to be considered a priority.
Methods Data of 135 patients undergoing laparoscopic TP adrenalectomy during a 20 year period has been analyzed. Both operative- (intraoperative blood loss, previous abdominal surgery, conversion rate, operative time, tumor size) and perioperative parameters [body mass index (BMI), American Society of Anesthesiologists (ASA) score, hospital stay, histology) were analyzed for malignant, large (LA) (6-10 cm) and extra-large (ELA) (10 cm<) lesions.
Results Out of a total 135 procedures, 18 malignant lesions (13,33%) were removed during TP adrenalectomy (11 metastasis, 6 adrenocortical carcinoma, 1 leiomyosarcoma). Complete, R0 resection was carried out in each case. Mean size of malignant lesions was 79.94 mm, previous abdominal surgery occurred in 77.77%, conversion was needed in 11.11%, mean intraoperative blood loss was 59.16 ml, mean hospital stay was 5.8 days, with mean operative time of 85.5 minutes. Among the 47 increased size lesions (LA: 40 vs ELA: 7), mean tumor size was 71.85 and 141.57 mm, rate of previous abdominal surgery 12 (30%) vs 5 (71.42%), mean intraoperative blood loss 64.47 ml vs 71.85 ml, hospital stay 5.10 vs 4.57 days, mean operative time 76.52 vs 79.28 minutes, mean BMI 23.45 vs 27.87, and mean ASA score 2.62 vs 2.42 for LA and ELA lesions, respectively. In terms of malignant lesions, 1 adrenocortical carcinoma and 4 metastases occurred in the LA-, and 3 adrenocortical carcinomas in the ELA group. Three ELA lesions (2 adrenocortical carcinomas and 1 neurofibroma) were removed through an additional mini-Pfannenstiel incision.
Conclusion Transperitoneal laparoscopic adrenalectomy proves to be a safe and feasible method in the removal of large-, extra-large-, and even malignant lesions. During the resection of malignant lesions, oncological radicality with complete resection is to be considered a priority.
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