International Consultation on Urological Diseases and European Association of Urology International Consultation on Minimally Invasive Surgery in Urology: laparoscopic and robotic adrenalectomy

被引:45
作者
Ball, Mark W. [1 ,2 ]
Hemal, Ashok K. [3 ]
Allaf, Mohamad E. [1 ,2 ]
机构
[1] Johns Hopkins Univ, Sch Med, James Buchanan Brady Urol Inst, 600 N Wolfe St Marburg 134, Baltimore, MD 21287 USA
[2] Johns Hopkins Univ, Sch Med, Dept Urol, 600 N Wolfe St Marburg 134, Baltimore, MD 21287 USA
[3] Wake Forest Sch Med, Dept Urol, Winston Salem, NC USA
关键词
guidelines; adrenalectomy; laparoscopy; robotics; #ProstateCancer; #PCSM; OPEN POSTERIOR ADRENALECTOMY; SINGLE-SITE ADRENALECTOMY; ADRENOCORTICAL CARCINOMA; RETROPERITONEAL ADRENALECTOMY; PRIMARY HYPERALDOSTERONISM; ASSISTED ADRENALECTOMY; LATERAL ADRENALECTOMY; PHEOCHROMOCYTOMA; TUMORS; OUTCOMES;
D O I
10.1111/bju.13592
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study was to provide an evidence-based systematic review of the use of laparoscopic and robotic adrenalectomy in the treatment of adrenal disease as part of the International Consultation on Urological Diseases and European Association of Urology consultation on Minimally Invasive Surgery in Urology. A systematic literature search (January 2004 to January 2014) was conducted to identify comparative studies assessing the safety and efficacy of minimally invasive adrenal surgery. Subtopics including the role of minimally invasive surgery for pheochromocytoma, adrenocortical carcinoma (ACC) and large adrenal tumours were examined. Additionally, the role of transperitoneal and retroperitoneal approaches, as well as laparoendoscopic single-site (LESS) and robotic adrenalectomy were reviewed. The major findings are presented in an evidence-based fashion. Large retrospective and prospective data were analysed and a set of recommendations provided by the committee was produced. Laparoscopic surgery should be considered the first-line therapy for benign adrenal masses requiring surgical resection and for patients with pheochromocytoma. While a laparoscopic approach may be feasible for selected cases of ACC without adjacent organ involvement, an open surgical approach remains the 'gold standard'. Large adrenal tumours without preoperative or intra-operative suspicion of ACC may be safely resected via a laparoscopic approach. Both transperitoneal and retroperitoneal approaches to laparoscopic adrenalectomy are safe. The approach should be chosen based on surgeon training and experience. LESS and robotic adrenalectomy should be considered as alternatives to laparoscopic adrenalectomy but require further study.
引用
收藏
页码:13 / 21
页数:9
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