Frattolillo G, Paradiso G, Scarano Catanazaro V, Giordano L, Avantifiori R, D'Ermo G, Letizia C, De Toma G
G Chir. 2020 Jan-Feb;41(1):46-490.
Over the past 25 years, mini-invasive adrenalectomy has become the treatment of choice for most adrenal diseases, and even adrenal malignancies in selected cases. The aim of this retrospective evaluation is to assess the effectiveness of laparoscopic adrenalectomy as a treatment of choice for adrenal metastases.
From 2008 to 2018, 207 laparoscopic adrenalectomies have been performed in our Department of Surgery. Among these, in 12 cases the indication to adrenalectomy was metastatic adrenal lesion.
The right adrenal gland was removed in 8 cases and the left adrenal gland in 4 cases. A complete resection (R0) was achieved in all patients. The median operative time was 130.6 ± 23.3 min. The median postoperative hospitalization was 3.5±2.0 days. Only one patient showed postoperative grade II complications, according to Clavien-Dindo classification. All patients underwent follow-up at 6-12-18 months without showing disease recurrence. There was no intra and perioperative mortality. Conversion to laparotomic surgery has never been performed. Mean tumor size was 2.4 cm ±1.6 cm.
Laparoscopic adrenalectomy for metastasis permits to achieve similar results to the open approach in term of oncological outcomes, but gaining in terms of postoperative hospitalization, intra and post-operative complications as well a greater patient compliance.
在过去25年中，微创肾上腺切除术已成为大多数肾上腺疾病的首选治疗方法，在某些特定病例中甚至对于肾上腺恶性肿瘤也是如此。这项回顾性评估的目的是评估腹腔镜肾上腺切除术作为肾上腺转移瘤首选治疗方法的有效性。
2008年至2018年期间，我们外科共进行了207例腹腔镜肾上腺切除术。其中，12例肾上腺切除术的指征为肾上腺转移瘤。
8例切除右侧肾上腺，4例切除左侧肾上腺。所有患者均实现了完整切除（R0）。中位手术时间为130.6±23.3分钟。中位术后住院时间为3.5±2.0天。根据Clavien-Dindo分类，仅1例患者出现术后II级并发症。所有患者均在6个月、12个月和18个月时接受随访，均未出现疾病复发。无围手术期及术中死亡情况。从未转为开腹手术。平均肿瘤大小为2.4 cm±1.6 cm。
腹腔镜肾上腺切除术治疗转移瘤在肿瘤学结局方面可取得与开放手术相似的结果，但在术后住院时间、术中及术后并发症以及患者依从性方面更具优势。
