Safety of Minimally Invasive Surgical Techniques in Large Adrenal Lesions: A Single-Centre Study

Objective: To compare perioperative outcomes of minimally invasive surgery for >= 5 cm and <5 cm adrenal lesions. Study Design: Retrospective cohort study. Place and Duration of Study: Hacettepe University School of Medicine, Ankara, Turkey, between October 2007 and September 2019. Methodology: Data of 83 patients operated for adrenal lesions was collected retrospectively. Patients were categorized into two groups based on the size of the adrenal gland as <5 cm and >= 5 cm. The groups were compared in terms of perioperative outcomes. Results: The median age of the patients was 51 (41-60) years, with a female-to-male ratio of 27/56. The median follow-up period was 27 (11.5-91) months. Of 83 adrenal masses, 60 (72.3%) were in the <5 cm group and 23 (27.7%) were in the >= 5 cm group. Fifteen (18.1%) patients underwent adrenalectomy for lung cancer metastasis, whereas three (3.6%) for renal cell carcinoma metastasis. The overall rate of post-operative complications was 10.8%. Post-operative complication rates were similar in each group (p=0.433). Operation time was found to be significantly higher in patients with large adrenal masses (p=0.003). Conclusion: Minimally invasive surgical techniques have the same perioperative results in the group with adrenal lesions >= 5 cm compared to <5 cm and may be safely employed in this group of patients.