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. 2025 Jul 22;14(15):5176.
doi: 10.3390/jcm14155176.

The Role of Minimally Invasive Adrenalectomy for Large Adrenal Tumors (≥6 cm): Evidence from a 10-Year Retrospective Study

Leonardo Rossi  1 , Chiara Becucci  1 , Ortensia Della Posta  1 , Piermarco Papini  1 , Francesca Palma  1 , Mattia Cammarata  1 , Luisa Sacco  1 , Klaudiya Dekova  1 , Suela Ajdini  1 , Carlo Enrico Ambrosini  1 , Gabriele Materazzi  1
Affiliations

The Role of Minimally Invasive Adrenalectomy for Large Adrenal Tumors (≥6 cm): Evidence from a 10-Year Retrospective Study

Leonardo Rossi et al. J Clin Med. .

Abstract

Background: The suitability of minimally invasive adrenalectomy (MIA) for adrenal tumors ≥6 cm remains debated due to technical challenges and oncological concerns. This study aimed to assess the safety and feasibility of MIA for large adrenal tumors by comparing surgical outcomes with smaller tumors. Methods: This retrospective cohort study included 269 patients who underwent MIA (2013-2023), divided into two groups: Group A (<6 cm, n = 197) and Group B (≥6 cm, n = 72). The primary endpoint was the postoperative complication rate; secondary endpoints included conversion to open surgery and postoperative length of stay (LOS). Results: Multivariate analysis identified no factors associated with postoperative complications; however, tumor size ≥ 6 cm was associated with conversion to open surgery (p = 0.031). Bilateral procedures and a higher Charlson comorbidity index were associated with longer LOS (p < 0.001 and p = 0.015, respectively). Conclusions: MIA is a safe and feasible approach for tumors ≥6 cm, despite being associated with a higher conversion rate.

Keywords: adrenalectomy; laparoscopic adrenalectomy; large adrenal tumors; retroperitoneoscopic; robotic adrenalectomy; surgical outcomes.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study flowchart of patient enrollment.
Figure 2
Figure 2
Clipping of the right middle adrenal vein during robotic LTA.
See this image and copyright information in PMC

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