Factors predicting success of laparoscopic adrenalectomy: Our experience

Abstract

Introduction: Adrenal is one of the most feared organs owing to its anatomical position. However, adrenalectomy by laparoscopic means has now been adopted as the procedure of choice to treat benign and malignant functioning and nonfunctioning adrenal tumors. We describe our experience with laparoscopic adrenalectomy (LA) in 37 patients at a tertiary institute and try to predict factors for open conversion. Materials and methods: Thirty-seven patients who underwent LA from August 2013 to February 2018 were retrospectively analyzed and factors leading to conversion to open adrenalectomy assessed. Results: Among 37 patients, 31 had pheochromocytoma on histopathology and 1 patient had adrenal hyperplasia leading to Cushing’s syndrome. Five out of 37 patients had to be converted to open technique—multiple adhesions with the bowel, retrocaval tumor extensions, difficult dissection, and prolonged operative time due to large tumor size (in two patients) and severe hepatomegaly were the reasons for conversion to open. Conclusion: Laparoscopic adrenalectomy is safe and feasible for large adrenal lesions.