Hirayama Takahiro, Fujita Tetsuo, Koguchi Dai, Nishi Morihiro, Kurosaka Shinji, Tsumura Hideyasu, Tabata Ken-Ichi, Iwamura Masatsugu
Department of Urology, Kitasato University School of Medicine, Sagamihara, Japan.
Asian J Endosc Surg. 2014 Jan;7(1):43-7. doi: 10.1111/ases.12076. Epub 2013 Nov 20.
Treating adrenal metastases from primary malignancies with laparoscopic adrenalectomy (LA) remains controversial. The aim of this study was to evaluate the feasibility, effectiveness and efficiency of LA for solitary adrenal metastasis.
From November 2003 to September 2012, eight consecutive patients with adrenal metastasis were treated with LA. A retrospective study was conducted, and clinical and histological data were analyzed.
All LA were successfully performed. There were no major complications, blood transfusions or conversions to open adrenalectomy. The patients included seven men and one woman with a median age of 59 years at the time of operation. Adrenal metastases were most commonly noted to be from non-small-cell lung cancer (four patients) and renal cell carcinoma (four patients). The majority of adrenal metastases were unilateral (right: one patient; left: seven patients). One patient had bilateral metastases. The median overall survival was 14 months. Four patients (two with non-small-cell lung cancer; two with renal cell carcinoma) were alive with no evidence of metastatic disease as of October 2013.
LA is a safe and effective procedure for patients with isolated metastases. Surgical resection with LA for a solitary adrenal metastasis from primary malignancy can achieve a good prognosis.
采用腹腔镜肾上腺切除术（LA）治疗原发性恶性肿瘤的肾上腺转移瘤仍存在争议。本研究的目的是评估LA治疗孤立性肾上腺转移瘤的可行性、有效性和效率。
2003年11月至2012年9月，连续8例肾上腺转移瘤患者接受了LA治疗。进行了一项回顾性研究，并分析了临床和组织学数据。
所有LA手术均成功完成。无重大并发症、输血或转为开放性肾上腺切除术的情况。患者包括7名男性和1名女性，手术时的中位年龄为59岁。肾上腺转移瘤最常见于非小细胞肺癌（4例）和肾细胞癌（4例）。大多数肾上腺转移瘤为单侧（右侧：1例；左侧：7例）。1例患者有双侧转移。中位总生存期为14个月。截至2013年10月，4例患者（2例非小细胞肺癌；2例肾细胞癌）存活，无转移疾病证据。
LA对于孤立性转移瘤患者是一种安全有效的手术方法。对于原发性恶性肿瘤的孤立性肾上腺转移瘤，采用LA进行手术切除可获得良好预后。
