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Laparoscopic adrenalectomy by transabdominal lateral approach: Should we be afraid of getting started? First 5 years of experience [Laparosc Endosc Surg Sci ]
Laparosc Endosc Surg Sci . 2019; 26(4): 149-155 | DOI: 10.14744/less.2019.90692

Laparoscopic adrenalectomy by transabdominal lateral approach: Should we be afraid of getting started? First 5 years of experience

Muhammet Kadri Çolakoğlu1, Ali Demir2, Ali Özdemir3, Suleyman Kalcan3, Gökhan Demiral3, Ahmet Pergel3, Uğur Avcı4
1Department of Gastrointestinal Surgery, Ankara City Hospital, Ankara, Turkey
2Department of General Surgery, Konya Training and Research Hospital, Konya, Turkey
3Department of General Surgery, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Turkey
4Department of Internal Medicine, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Turkey

INTRODUCTION: A laparoscopic approach has become the standard procedure for removing adrenal masses. However, the need for experience with the technique continues to be emphasized. The aim of this study was to retrospectively review the first 5 years of data of patients who had an adrenal mass and underwent laparoscopic surgery with a transabdominal lateral approach.
METHODS: All of the patients at a single institution who were operated on for an adrenal mass using a laparoscopic transabdominal lateral approach between January 2014 and January 2019 were included. The demographic data, any history of other abdominal surgery, American Society of Anesthesiologists score, preoperative diagnosis, hormonal characteristics of the tumor, intraoperative parameters, intra- and postoperative complications, and the histological diagnosis were analyzed.
RESULTS: A total of 42 laparoscopic adrenalectomy procedures were performed. The mean age of the patients was 50.64±13.22 years. The lesion was located on the right side in 52.3% of the patients. Nine patients (21.4%) had previously undergone abdominal surgery for various reasons. The majority of the adrenal masses were a secretory adenoma or hyperplasia of the gland. Four patients were operated on for metastasis of other malignancies and others were non-secreting tumors. The mean size of the adrenal lesions was 29.4±12.7 mm. The mean operative time was 140.45 minutes and the mean blood loss was 62.9 mL. Intraoperative complications occurred in 3 cases (7.1%). Complications were observed postoperatively in 9 patients (21.4%). The mean length of hospitalization was 3.8±2.1 days.
DISCUSSION AND CONCLUSION: A laparoscopic adrenalectomy proved to be a safe and feasible method, even in cases in which it was the operator’s first experience with the procedure. The results of a first application were similar to those reported in the literature. However, we strongly believe that other prior laparoscopic experience is required to achieve these results.

Keywords: Adrenalectomy, laparoscopy; transabdominal

Transabdominal lateral yaklaşımla laparoskopik adrenalektomi. Başlamaktan korkmalı mıyız? İlk 5 yıl deneyimi

Muhammet Kadri Çolakoğlu1, Ali Demir2, Ali Özdemir3, Suleyman Kalcan3, Gökhan Demiral3, Ahmet Pergel3, Uğur Avcı4
1Ankara Şehir Hastanesi, Gastroenteroloji Cerrahisi Kliniği, Ankara, Türkiye
2Konya Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, Konya, Türkiye
3Recep Tayyip Erdoğan Üniversitesi, Genel Cerrahi Anabilim Dalı, Rize, Türkiye
4Recep Tayyip Erdoğan Üniversitesi, İç Hastalıkları Anabilim Dalı, Rize, Türkiye

GİRİŞ ve AMAÇ: Adrenal kitlelere laparoskopik yaklaşım standart prosedür haline gelmiştir. Ancak yine de deneyimli merkezlerde gerçekleştirilmesi gerektiği vurgulanmaktadır. Bu çalışmanın amacı, adrenal kitleleri olan ve laparoskopik transabdominal lateral yaklaşım uygulanan hastaların ilk 5 yıl verilerini geriye dönük olarak incelemektir.
YÖNTEM ve GEREÇLER: Ocak 2014 ile Ocak 2019 arasında laparoskopik transabdominal lateral yaklaşımla opere edilen tüm hastalar çalışmaya dahil edildi. Demografik veriler, preoperatif abdominal cerrahi öyküsü, Amerikan Anestezi Uzmanları Derneği skorları, preoperatif tanı, tümörün hormonal özellikleri, intraoperatif parametreler, intra ve postoperatif komplikasyonlar ve histolojik tanı analiz edildi.
BULGULAR: Toplam 42 laparoskopik adrenalektomi işlemi yapıldı. Yaş ortalaması 50.64 ± 13.22 idi. Lezyon hastaların% 52.3'ünde sağ taraftaydı. Dokuz hasta (% 21.4) daha önce çeşitli nedenlerle abdominal cerrahi geçirmişti. Adrenal kitlelerin çoğunluğu sekretuvar adenom veya bezin hiperplazisi idi. Dört hasta, diğer malignitelerin metastazı nedeniyle ameliyat edildi ve diğerleri, non-sekretuvar tümörlerdi. Ortalama adrenal lezyon büyüklüğü 29.4 ± 12.7 mm idi. Ortalama ameliyat süresi 140.45 dk idi. Ortalama kan kaybı 62.9 ml idi. İntraoperatif komplikasyonlar üç olguda (% 7.1) görüldü. Postoperatif dokuz hastada (% 21.4) komplikasyon gözlendi. Ortalama hastanede yatış günü 3.8 ± 2.1 idi.
TARTIŞMA ve SONUÇ: Laparoskopik adrenalektomi, ilk deneyimde bile güvenli ve uygulanabilir bir yöntemdir. İlk uygulamaların sonuçları literatüre benzer. Ancak, bu sonuçları elde etmek için laparoskopik tecrübenin gerekli olduğuna inanmaktayız.

Anahtar Kelimeler: laparoskopi, adrenalektomi, transabdominal

Muhammet Kadri Çolakoğlu, Ali Demir, Ali Özdemir, Suleyman Kalcan, Gökhan Demiral, Ahmet Pergel, Uğur Avcı. Laparoscopic adrenalectomy by transabdominal lateral approach: Should we be afraid of getting started? First 5 years of experience. Laparosc Endosc Surg Sci . 2019; 26(4): 149-155

Corresponding Author: Muhammet Kadri Çolakoğlu, Türkiye
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