Are Adrenal Lesions of 6 cm or More in Diameter a Contraindication to Laparoscopic Adrenalectomy? A Case-Control Study

被引:17
作者
Balla, Andrea [1 ]
Palmieri, Livia [1 ]
Meoli, Francesca [1 ]
Corallino, Diletta [1 ]
Ortenzi, Monica [2 ]
Ursi, Pietro [1 ]
Guerrieri, Mario [2 ]
Quaresima, Silvia [1 ]
Paganini, Alessandro M. [1 ]
机构
[1] Sapienza Univ Rome, Dept Gen Surg, Surg Specialties "Paride Stefanini", Azienda Policlin Umberto, Viale Policlin 155, I-00161 Rome, Italy
[2] Univ Politecn Marche, Dept Gen Surg, Piazza Roma 22, I-60121 Ancona, Italy
关键词
TRANSPERITONEAL ANTERIOR; RESECTION; TUMORS; PHEOCHROMOCYTOMAS; MANAGEMENT; LARGER; SIZE;
D O I
10.1007/s00268-019-05287-2
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background The aim of this case-control study is to compare the surgical outcomes of laparoscopic adrenalectomy (LA) for lesions measuring >= 6 cm versus <= 5.9 cm in diameter. Methods Eighty-one patients with adrenal gland lesions >= 6 cm in diameter (intervention group) were identified. Patients were matched to 81 patients with adrenal gland <= 5.9 cm in diameter (control group) based on disease (Conn-Cushing syndrome, pheochromocytoma, primary or secondary adrenal cancer or other disease), lesion side (right, left), surgical technique (anterior transperitoneal approach for right and left LA or anterior transperitoneal submesocolic for left LA) and body mass index class (18-24.9, 25-29.9, 30-34.9, 35-39.9, >= 40 kg/m(2)). Surgical outcomes were compared between the intervention and control groups. Results Mean operative time was statistically significantly longer in the interventional arm (101.4 +/- 52.4 vs. and 85 +/- 31.6 min, p = 0.0174). Eight conversions were observed in the intervention group (9.8%) compared to four in the control group (4.9%) (p = 0.3690). Five (6.1%) and three (3.7%) postoperative complications were observed in the intervention and control groups, respectively (p = 0.7196). Mean postoperative hospital stay was 4.6 +/- 2.4 and 4.1 +/- 2.3 days in the intervention and control groups, respectively (p = 0.1957). Conclusions Operative time was statistically significantly longer in adrenal gland lesions >= 6 cm in diameter (vs. <= 5.9 cm). Conversion and complication rates were also higher, but the difference was not statistically significant. Based on the present data, adrenal gland lesions >= 6 cm in diameter are not an absolute contraindication to the laparoscopic approach.
引用
收藏
页码:810 / 818
页数:9
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