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Laparoscopic adrenalectomy — a review of initial 24 consecutive patients

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Abstract

Aim

To analyze patient demographics, pathology, surgical procedure and outcome in initial 24 consecutive patients who underwent laparoscopic adrenalectomy in our department.

Methods

Twenty four patients underwent laparoscopic adrenalectomy between September 2000 and August 2005. There were 12 males and 12 females with a mean age of 44.6 years (range 25–68 years). The indications for adrenalectomy were pheochromocytoma (13 patients), Cushing’s syndrome (5 patients), myelolipoma (2 patients), adrenal cyst (2 patients), aldosteronoma (1 patient) and adrenal incidentaloma (1 patient). Nineteen of our patients with functioning adrenal tumours were prepared preoperatively for periods ranging up to 2 weeks by the endocrinologist. All laparoscopic adrenalectomies were performed via lateral transperitoneal approach using standard four-port technique. Patients with pheochromocytoma and Cushing’s syndrome were monitored in the surgical intensive care unit during immediate postoperative period. The clinical and intraoperative characteristics, complications and outcomes of all patients were analyzed.

Results

The mean operative time for laparoscopic adrenalectomy was 136 minutes. Intraoperative hypertension occurred in 8 patients. Intraoperative hypotension occurred in 2 patients. One patient required conversion due to dense adhesions and hemorrhage. Postoperative complications were seen in six patients — immediate postoperative hypotension (2 patients), features of steroid withdrawal (2 patients) and postoperative pyrexia (2 patients). Five patients with pheochromocytoma required antihypertensive drugs in the postoperative period. There was no mortality in our series.

Conclusions

Laparoscopic adrenalectomy is a safe operation that incorporates all the benefits of minimal access surgery and is associated with a satisfactory postoperative outcome. A careful preoperative preparation in functioning adrenal tumours aids in the faster recovery of these patients.

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Authors and Affiliations

  1. Consultant Surgeon Minimal Access and Bariatric Surgery Center, Sir Ganga Ram Hospital, Room No. 200 (IInd floor), New Delhi, 110 060, India

    R. Venkatasubramanian, Atul Wadhwa, Anil Sharma, Rajesh Khullar, Vandana Soni, Manish Baijal & P. K. Chowbey

Authors
  1. R. Venkatasubramanian
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  2. Atul Wadhwa
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  3. Anil Sharma
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  4. Rajesh Khullar
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  5. Vandana Soni
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  6. Manish Baijal
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  7. P. K. Chowbey
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Corresponding author

Correspondence to Anil Sharma.

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Venkatasubramanian, R., Wadhwa, A., Sharma, A. et al. Laparoscopic adrenalectomy — a review of initial 24 consecutive patients. Indian J Surg 69, 129–135 (2007). https://doi.org/10.1007/s12262-007-0003-7

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  • DOI: https://doi.org/10.1007/s12262-007-0003-7

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