The role of laparoscopic surgery in isolated adrenal metastasis: our personal experience.

IF 0.4 Q4 SURGERY

Giornale di Chirurgia Pub Date : 2020-01-01

G Frattolillo, G Paradiso, V Scarano Catanazaro, L Giordano, R Avantifiori, G D'Ermo, C Letizia, G De Toma

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引用次数: 0

Abstract

Background: Over the past 25 years, mini-invasive adrenalectomy has become the treatment of choice for most adrenal diseases, and even adrenal malignancies in selected cases. The aim of this retrospective evaluation is to assess the effectiveness of laparoscopic adrenalectomy as a treatment of choice for adrenal metastases.

Methods: From 2008 to 2018, 207 laparoscopic adrenalectomies have been performed in our Department of Surgery. Among these, in 12 cases the indication to adrenalectomy was metastatic adrenal lesion.

Results: The right adrenal gland was removed in 8 cases and the left adrenal gland in 4 cases. A complete resection (R0) was achieved in all patients. The median operative time was 130.6 ± 23.3 min. The median postoperative hospitalization was 3.5±2.0 days. Only one patient showed postoperative grade II complications, according to Clavien-Dindo classification. All patients underwent follow-up at 6-12-18 months without showing disease recurrence. There was no intra and perioperative mortality. Conversion to laparotomic surgery has never been performed. Mean tumor size was 2.4 cm ±1.6 cm.

Conclusions: Laparoscopic adrenalectomy for metastasis permits to achieve similar results to the open approach in term of oncological outcomes, but gaining in terms of postoperative hospitalization, intra and post-operative complications as well a greater patient compliance.

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腹腔镜手术在孤立性肾上腺转移中的作用:我们的个人经验。

背景:在过去的25年中，微创肾上腺切除术已成为大多数肾上腺疾病的治疗选择，甚至在某些情况下，肾上腺恶性肿瘤也是如此。本回顾性评估的目的是评估腹腔镜肾上腺切除术作为肾上腺转移瘤治疗选择的有效性。方法:2008年至2018年，我科共施行腹腔镜肾上腺切除术207例。其中，有12例肾上腺切除术的指征为转移性肾上腺病变。结果:右肾上腺8例，左肾上腺4例。所有患者均获得完全切除(R0)。中位手术时间为130.6±23.3 min，中位住院时间为3.5±2.0 d。根据Clavien-Dindo分级，仅有1例患者出现术后II级并发症。随访6-12-18个月，无复发。术中及围手术期均无死亡。转为剖腹手术从未进行过。平均肿瘤大小为2.4 cm±1.6 cm。结论:在肿瘤预后方面，腹腔镜肾上腺转移切除术可以达到与开放入路相似的结果，但在术后住院、术中和术后并发症以及更高的患者依从性方面有所增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Giornale di Chirurgia SURGERY-

CiteScore

1.10

自引率

0.00%

发文量

期刊介绍： Il Giornale di Chirurgia pubblica contributi che propongono le diverse tecniche su patologia chirurgiche di attualità. Pubblica articoli originali, casistica clinica, metodi, tecniche, terapia farmacologica pre-operatoria e post-chirurgica, ed articoli inerenti la descrizione di tecniche chirurgiche.