Should We Use Laparoscopic Adrenalectomy for Metastases? Scandinavian Multicenter Study

Introduction: Laparoscopic adrenalectomy for metastases is considered controversial. Multicenter retrospective study was performed to,am new knowledge in this issue. Materials and Methods: From January 1997 till November 2008, 41 adrenalectomies were performed during follow-Lip of the patients operated for malignant tumors. The median age was 64 (52-77) years. Metastases were confirmed in 31/41 cases. Metastatic lesions were further Studied and to define factors influencing on Survival, patients were divided to sub-groups of metachronous/synchronous, tumor origin and tumor size. Results: The median operative time was 104 (50-230) min, the median blood loss was 100 (0-500) ml. One procedure (3.2%) was converted. There were 3 (10.7%) intraoperative and 2 (7.4%) postoperative complications. The median tumor size was 6 (1.5-16) cm. Pathohistological analysis revealed 12 colorectal, 9 renal cell carcinoma, 5 lung carcinoma, 4 melanoma,and I hepatocellular metastases. The resection margin was not free in one case (3.7%). The median hospital stay was 2 (1-21) clays. The median length Of Survival was 29 +/- 2.1 months for all patients. Conclusion: Laparoscopic adrenalectomy for metastases is feasible regardless of their sizes. However these procedures should be performed by highly skilled laparoscopic surgeon in a fully equipped operating room and with a coordinated operation team. J. Surg. Oncol. 2009; 100: 43-47. (C) 2009 Wiley-Liss, Inc.