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Transperitoneal laparoscopic adrenalectomy in children.

Catellani B, Acciuffi S, Biondini D, Ceccarelli PL, Cacciari A, Gelmini R - JSLS (2014 Jul-Sep)

Bottom Line: The aim of our study was to describe the safety and feasibility of minimally invasive adrenalectomy in children on the basis of surgical skills and results.None of the patients showed signs of recurring disease at 15-month follow-up.It also provides good visibility and easy access to other organs.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery.

ABSTRACT

Purpose: The use of a minimally invasive approach for adrenalectomy is poorly defined in pediatric patients, although laparoscopic adrenalectomy is considered a standard procedure in adults. The aim of our study was to describe the safety and feasibility of minimally invasive adrenalectomy in children on the basis of surgical skills and results.

Materials and methods: This was a retrospective study of 4 pediatric laparoscopic adrenalectomies performed at our center between 2009 and 2012. All patients underwent transperitoneal lateral laparoscopic adrenalectomies (2 right and 2 left adrenalectomies).

Results: Four laparoscopic adrenalectomies were performed. Indications for surgery were neuroblastoma in 2 patients, secernent adrenocortical tumor in 1 patient, and adrenocortical nodular hyperplasia in 1 patient. Patients had a mean age of 87 months (range, 17-156 months) at diagnosis, and the average lesion size was 3.23 cm (range, 0.7-6.4 cm). All laparoscopic adrenalectomies were successful, no conversions to open surgery were required, and no postoperative complications or deaths occurred. The average operating time was 105 minutes (range, 80-130 minutes), blood loss during surgery was minimal, and the mean postoperative hospital stay was 3.75 days (range, 3-5 days). None of the patients showed signs of recurring disease at 15-month follow-up.

Conclusions: Laparoscopic adrenalectomy is a safe, feasible, and reproducible technique offering numerous advantages, including shortening of operating times and postoperative hospital stays, as well as reduction of blood loss and complications. It also provides good visibility and easy access to other organs.

No MeSH data available.


Related in: MedlinePlus

Left neuroblastoma on computed tomography: longitudinal section.
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Figure 2: Left neuroblastoma on computed tomography: longitudinal section.

Mentions: This was a retrospective study of all laparoscopic adrenalectomies performed on pediatric patients at our institution between April 2009 and August 2012 by a single surgeon. In the same period, 5 open pediatric adrenalectomies were performed by the same operating team. Four transperitoneal lateral laparoscopic adrenalectomies were carried out. All patients underwent preoperative evaluations including endocrinologic investigation to determine secretory activity. Additionally, all patients were studied with ultrasonography, computed tomography, or magnetic resonance imaging to assess the side, the size, the local extent, and the operability of the primary lesion (Figures 1–3). When necessary, metaiodobenzylguanidine scintigraphy was performed. Intraoperative variables considered were operating time, blood loss, rate of conversion, and additional procedures. Postoperative end points were time of resumption of oral intake, return to bowel function, hospital stay, surgical and medical complications, histopathologic diagnosis, size of lesion at the pathologic examination, and cosmetic results. Follow-up focused on recurrence rate, onset of metastasis, overall survival, disease-free survival, and death.


Transperitoneal laparoscopic adrenalectomy in children.

Catellani B, Acciuffi S, Biondini D, Ceccarelli PL, Cacciari A, Gelmini R - JSLS (2014 Jul-Sep)

Left neuroblastoma on computed tomography: longitudinal section.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4208910&req=5

Figure 2: Left neuroblastoma on computed tomography: longitudinal section.
Mentions: This was a retrospective study of all laparoscopic adrenalectomies performed on pediatric patients at our institution between April 2009 and August 2012 by a single surgeon. In the same period, 5 open pediatric adrenalectomies were performed by the same operating team. Four transperitoneal lateral laparoscopic adrenalectomies were carried out. All patients underwent preoperative evaluations including endocrinologic investigation to determine secretory activity. Additionally, all patients were studied with ultrasonography, computed tomography, or magnetic resonance imaging to assess the side, the size, the local extent, and the operability of the primary lesion (Figures 1–3). When necessary, metaiodobenzylguanidine scintigraphy was performed. Intraoperative variables considered were operating time, blood loss, rate of conversion, and additional procedures. Postoperative end points were time of resumption of oral intake, return to bowel function, hospital stay, surgical and medical complications, histopathologic diagnosis, size of lesion at the pathologic examination, and cosmetic results. Follow-up focused on recurrence rate, onset of metastasis, overall survival, disease-free survival, and death.

Bottom Line: The aim of our study was to describe the safety and feasibility of minimally invasive adrenalectomy in children on the basis of surgical skills and results.None of the patients showed signs of recurring disease at 15-month follow-up.It also provides good visibility and easy access to other organs.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery.

ABSTRACT

Purpose: The use of a minimally invasive approach for adrenalectomy is poorly defined in pediatric patients, although laparoscopic adrenalectomy is considered a standard procedure in adults. The aim of our study was to describe the safety and feasibility of minimally invasive adrenalectomy in children on the basis of surgical skills and results.

Materials and methods: This was a retrospective study of 4 pediatric laparoscopic adrenalectomies performed at our center between 2009 and 2012. All patients underwent transperitoneal lateral laparoscopic adrenalectomies (2 right and 2 left adrenalectomies).

Results: Four laparoscopic adrenalectomies were performed. Indications for surgery were neuroblastoma in 2 patients, secernent adrenocortical tumor in 1 patient, and adrenocortical nodular hyperplasia in 1 patient. Patients had a mean age of 87 months (range, 17-156 months) at diagnosis, and the average lesion size was 3.23 cm (range, 0.7-6.4 cm). All laparoscopic adrenalectomies were successful, no conversions to open surgery were required, and no postoperative complications or deaths occurred. The average operating time was 105 minutes (range, 80-130 minutes), blood loss during surgery was minimal, and the mean postoperative hospital stay was 3.75 days (range, 3-5 days). None of the patients showed signs of recurring disease at 15-month follow-up.

Conclusions: Laparoscopic adrenalectomy is a safe, feasible, and reproducible technique offering numerous advantages, including shortening of operating times and postoperative hospital stays, as well as reduction of blood loss and complications. It also provides good visibility and easy access to other organs.

No MeSH data available.


Related in: MedlinePlus