Adrenalectomy for benign and malignant adrenal tumors. Experience from Misurata Cancer Center.

Abstract

Background: Laparoscopic adrenalectomy is the standard management of benign adrenal tumors. Open adrenalectomy is still the gold standard surgical treatment for adrenocortical carcinoma and malignant pheochromocytoma, while the role of minimal invasive surgery is still controversial. Laparoscopic adrenalectomy is associated with low morbidity rate, short hospital stay and rapid recovery to work. The aim of the study is identifying the advantages of laparoscopic adrenalectomy in comparison to open adrenalectomy.

Methods: We present a retrospective study of 21 adrenal tumors that underwent surgical resection at Misurata Cancer Center from April 2013 up to April 2018. We compared: age, sex, marital status, past medical history, function and size of the tumor, type of surgery, duration of surgery, estimated blood loss, preparation of patient for surgery, post-operative complications, post-operative discharge day and mortality.

Results: There were 21 adrenal tumors, 61.9% were females and 38.1% were males, median age 41 years. 61.9% were hypertensive patients, 71.4% functional tumors and 28.6% nonfunctional tumors. 71.4% benign tumors and 28.6% malignant. Laparoscopic adrenalectomy was done in 15 cases (71.4%), open adrenalectomy in 6 cases (28.6%), and 4 cases (19%) were converted to open surgery. Morbidity was 19%, and 30 days mortality rate was 4.7%.

Conclusion: Surgical treatment of adrenal tumors consists of laparoscopic and open adrenalectomy. The type of surgery depends on the size of the tumor and suspicious of malignancy in imaging study. Laparoscopic adrenalectomy is safe and effective for benign tumors with decreased operative time, less post-operative pain, and decreased hospital stay.