Delineating the role of laparoscopy in the treatment of large suprarenal masses

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Background: Laparoscopic adrenalectomy (LA) for large adrenal tumors is controversial due to the risk of malignancy and difficult dissection.This study aims to evaluate the safety, efficacy, and feasibility of transperitoneal LA in patients with large adrenal tumors measuring 6 cm or more in diameter.Patients and Methods: Forty patients with adrenal tumors were divided into two groups according to the size (group I≥6 cm and group II < 6 cm in diameter).In both groups demographic variables, tumor side and size, pathological diagnosis, operative time, conversion to open approach, estimated blood loss, intra and postoperative complications were compared.Results: No significant difference was found between the two groups regarding demographic data including age, sex and BMI.Estimated blood loss in group i ranged from 100.0 to 400.0 ml with mean value 180.0±95.15and in group II ranged from 100.0 to 300.0 ml with mean value 147.50±71.59.conversion to open approach was recorded in one (5%) patient in group I in a right sided 13 cm diameter tumor and no conversion was recorded in group II the operative time was significantly longer in group I with a mean duration of 2.04±0.5 h while in group II was 1.67±0.31h (P=0.020).there was no significant difference between the two groups in the intra and postoperative complications and length of hospital stay.Conclusion: LA for adrenal tumors greater than or equal to 6 cm in diameter is feasible and can be safely performed.More studies including a larger number of patients is needed to confirm our data.

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