LAPAROSCOPIC ADRENAL-SPARING SURGERY CASE SERIES: PARTIAL ADRENALECTOMY AND CYST RESECTION

Abstract

The aim is to present our case series documenting indications, laparoscopic technique, surgical and endocrinologic outcomes of laparoscopic partial adrenalectomy. In the period from April 2011 until October 2021, we performed 39 procedures. The patients were divided into three groups: unilateral adrenal gland tumor with a normal contralateral gland (group 1), tumor of the solitary adrenal gland (group 2), and adrenal cysts (group 3). There were 20 patients in group 1, 6 patients in group 2, and 13 patients in group 3. The most common histology in group 1 was adenoma (40%), all tumors in group 2 were renal cell carcinoma metastases, and all cysts in group 3 were benign. There were no major complications (Clavien Dindo grade ≥2) in the whole cohort. All patients in groups 1 and 3 had favorable endocrinologic outcomes, and 50% of group 2 patients required lifelong hydrocortisone replacement therapy. The procedure is safe and feasible with favorable outcomes in the hands of a high volume adrenal surgeon.

Keywords: Adrenalectomy; Laparoscopy; Minimally invasive surgery; Organ sparing treatments.

Fig. 1

Preoperative diagnostic magnetic resonance imaging, photographs of intraoperative anatomic relations and adrenal gland after partial adrenalectomy for right-sided adrenal tumor. (A) T1 weighted MR image showing favorable anatomic position (white circle); (B) tumor (black circle), adrenal vein (black lines), normal adrenal tissue (white lines), inferior vena cava (pink line), renal vein (purple lines); (C) resected tumor (black oval), adrenal gland remnant (purple area), liver held with a retractor (white line), inferior vena cava (pink line).