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. 2017 Aug;6(4):350-354.
doi: 10.21037/gs.2017.03.20.

The role of laparoscopic resection of metastases to adrenal glands

Marco Puccini  1 , Erica Panicucci  2 , Vincenzo Candalise  1 , Cristina Ceccarelli  1 , Carlo Maria Neri  1 , Piero Buccianti  1 , Paolo Miccoli  1
Affiliations

The role of laparoscopic resection of metastases to adrenal glands

Marco Puccini et al. Gland Surg. 2017 Aug.

Abstract

Background: The potential role of the laparoscopic approach for metastases to the adrenal gland is debated. We review here a series of patients consecutively submitted to laparoscopic adrenalectomy (LA) for suspected adrenal metastasis (AM).

Methods: Retrospective study (consecutive series) of LA for AM. We measured parameters associated to primary tumor and metastasis. Statistical analysis: stepwise regression model.

Results: Thirty-seven LA were performed on 36 patients. The mean age was 62.1 yrs. The side was right in 13 cases. Primary tumor was in the lung (n=22), breast (n=4), colon-rectum (n=4), kidney (n=3), thyroid, melanoma and ovary (n=1 each). Thirty-three out of 37 were confirmed to be AM (mean diameter 50 mm). Twenty-five were single metastasis. One LA was converted due to cava vein infiltration. Mean operative time was 142 min', median p.o. hospital stay was 3 days. After a mean follow-up of 33 months, 9 patients (25%) were alive free of disease, 6 (17%) were alive with disease. Mean post-adrenalectomy DFI was 19 months (range, 0-97 months), and it was the most predictive variable for survival (P<0.001).

Conclusions: The dimensions and absence of invasion on imaging, the evolutive status of the disease and the performance status of the patient are key factors for LA, which is associated with adequate oncologic results, a quicker postoperative recovery, and potential survival benefits.

Keywords: Adrenal tumor; adrenal metastasis (AM); laparoscopic adrenalectomy (LA); minimally invasive surgery; oncologic surgery.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

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