caa a22 4500 475803809 CHVBK 20180406123745.0 cr unu---uuuuu 170329e20001101xx s 000 0 eng 10.1007/s002680010222 doi (NATIONALLICENCE)springer-10.1007/s002680010222 Complications of Laparoscopic Adrenalectomy: Results of 169 Consecutive Procedures [Elektronische Daten] [Jean-François Henry, Thierry Defechereux, Marco Raffaelli, Denis Lubrano, Luis Gramatica] Laparoscopic adrenalectomy (LA) has become the gold standard for adrenalectomy. Review of the literature indicates that the rate of intra- and postoperative complications is not negligible. The aim of this study was to evaluate the complications observed in a series of 169 consecutive LAs performed at a same center for a variety of endocrine disorders. Between June 1994 and December 1998 a series of 169 LAs were performed in 159 patients: 149 unilateral LAs and 10 bilateral LAs. There were 98 women and 61 men with a mean age of 49.7 years (range 22-76 years). There were patients with 61 Conn syndrome, 41 with Cushing syndrome, 1 androgen-producing tumor, 29 pheochromocytomas, and 37 nonfunctioning tumors. Mean tumor size was 32 mm (range 7-110 mm). LA was performed by a transperitoneal flank approach in the lateral decubitus position. Mean operating time was 129 minutes (range 48-300 minutes) for unilateral LA and 228 minutes (range 175-275 minutes) for bilateral LA. There was no mortality. Twelve patients had a significant complication (7.5%): three peritoneal hematomas requiring (in two cases) laparotomy and (in one case) transfusion; one parietal hematoma; three intraoperative bleeding episodes without need for transfusion; one partial infarction of the spleen; one pneumothorax; one capsular effraction of the tumor; and two deep venous thromboses. Eight tumors were malignant at final histology (4.7%), of which four were completely removed laparoscopically. Conversion to open surgery was required in eight cases (5%): for malignancy in four cases, difficulty of dissection in three cases, and pneumothorax in one case. With a mean follow-up of 26.58 months (range 6-60 months) all patients are disease-free. We conclude that LA is a safe procedure. With increasing experience the morbidity becomes minor. To avoid complications LA should be converted to open surgery if local invasion is suspected or if there is difficulty with the dissection. Société Internationale de Chirurgie, 2000 Henry Jean-François Department of Endocrine Surgery, University Hospital la Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 05, France, FR aut Defechereux Thierry Department of Endocrine Surgery, University Hospital la Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 05, France, FR aut Raffaelli Marco Department of Endocrine Surgery, University Hospital la Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 05, France, FR aut Lubrano Denis Department of Endocrine Surgery, University Hospital la Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 05, France, FR aut Gramatica Luis Department of Endocrine Surgery, University Hospital la Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 05, France, FR aut World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1342-1346 0364-2313 24:11<1342 2000 24 268 https://doi.org/10.1007/s002680010222 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010222 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Henry Jean-François Department of Endocrine Surgery, University Hospital la Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 05, France, FR aut NATIONALLICENCE 700 1- Defechereux Thierry Department of Endocrine Surgery, University Hospital la Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 05, France, FR aut NATIONALLICENCE 700 1- Raffaelli Marco Department of Endocrine Surgery, University Hospital la Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 05, France, FR aut NATIONALLICENCE 700 1- Lubrano Denis Department of Endocrine Surgery, University Hospital la Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 05, France, FR aut NATIONALLICENCE 700 1- Gramatica Luis Department of Endocrine Surgery, University Hospital la Timone, Boulevard Jean Moulin, 13385 Marseilles Cedex 05, France, FR aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1342-1346 0364-2313 24:11<1342 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer