Laparoscopic adrenalectomy single-center experience, does size matter?

INTRODUCTION: Today, with the increase in the use of computerized tomography and magnetic resonance imaging in clinical practice, the frequency of detection of adrenal mass has gradually increased. When a mass is detected incidentally in the adrenal gland, it should be investigated whether it is functional and has a malignant potential. In this study, patients treated in our clinic for adrenal mass were reviewed.
METHODS: Patients who underwent laparoscopic adrenalectomy in the General Surgery Clinic of Haseki Training and Research Hospital between January 2018 and July 2023 were retrospectively reviewed. The recorded data consist of demographic information, surgery performed, duration of surgery, biochemical and hormonal laboratory values, radiological findings, surgery indication, terminal pathology results, hospital stay, complications, and mortality and morbidity data. The patients were divided into two groups according to tumor size and compared in terms of surgical results.
RESULTS: Forty-five patients, 10 male and 35 female, were included in the study. When the group with tumor size smaller than 6 cm and the group with a tumor size of 6 cm or larger were compared, a significant difference was found in terms of operation time (p<0.002). There was no difference in complication rates.
DISCUSSION AND CONCLUSION: In the management of an adrenal mass, hormonal evaluation of the tumor and its size determine the surgical approach decision. A multidisciplinary approach is required in cases with suspected malignancy and in cases where the tumor is functional. Currently, the gold standard in the surgical treatment of adrenal masses is the laparoscopic approach.