Ömer KURT, Cenk Murat YAZICI, Cüneyt TURAN

Lateral Transperitoneal Laparoskopik Adrenalektomi: Tek Merkez Deneyimi

Amaç: Laparoskopik adrenalektomi, benign adrenal kitlelerin tedavisinde altın standart yöntem olarak kabul edilmektedir. Ancak birçok cerrah, benign adrenal kitle tedavisinde açık cerrahiyi tercih etmektedir. Bu tercihin nedeni, cerrahların laparoskopik adrenal cerrahinin ileri düzey laparoskopik cerrahi olduğunu ve öğrenme eğrisinin yüksek olduğunu düşünmeleri olabilir. Bu çalışmada, transperitoneal laparoskopik adrenalektomi cerrahisi sonuçlarımızı bildirmeyi amaçladık. Yöntemler: 2013 ile 2015 tarihleri arasında Namık Kemal Üniversitesi Tıp Fakültesi Hastanesin Üroloji Anabilim Dalında yapılmış olan laparoskopik adrenalektomi vakalarının verileri retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, adrenal kitle patolojileri, kanama miktarı, hastanede kalış süreleri ve komplikasyonlar değerlendirildi. Bulgular: Toplam 21 hastanın verileri değerlendirildi. Bu hastaların 12'sine (%57,1) sağ adrenalektomi yapılırken, 9'una (%42,9) sol adrenalektomi uygulandı. Hastaların ortalama operasyon süresi 130,2±39, dk, ortalama kanama miktarı 197,6±72,4 ml ve ortalama hastanede kalış süresi 3,09±1,57 gün olarak tespit edildi. Patolojik değerlendirmede hastaların 4'ünde feokromasitoma, birinde miyeloma ve 16'sında adenoma olduğu tespit edildi. Boyut olarak 5 cm'den büyük kitlelerde kanama miktarı, operasyon süresi ve hastanede kalış süresi, 5 cm'den daha küçük kitlelere gore belirgin anlamda yüksek tespit edildi (p

Lateral Transperitoneal Laparoscopic Adrenalectomy: A Single Center Experience

Objective: Laparoscopic adrenalectomy is the gold standard surgical technique for benign adrenal tumors. On the other hand, most surgeons still prefer to perform open surgery for adrenal tumors. This may be related with the surgeons opinions that laparoscopic adrenalectomy is an advanced laparoscopic surgery and has a high learning curve. In this article we present the results of our initial transperitoneal laparoscopic adrenalectomy cases.Methods: Lateral transperitoneal laparoscopic adrenalectomy cases that were performed between 2013 and 2015, were retrospectively analyzed. Patients demographics, pathological types, operation time, blood loss, hospitalization time and complications were evaluated and compared with the literature. Results: A total of 21 patients were analyzed. Twelve (57.1%) patients had right and 9(42.9%) patients had left laparoscopic adrenalectomy. Mean operation time was 130.2±39.1 min, mean blood loss was 197.6±72.4 ml and mean hospitalization time was 3.09±1.57 days. Pathology reports of adrenal tumors were pheochromocytoma at 4 patients, myeloma at 1 patient and adenoma at 16 patients. Patients with tumor size > 5 cm had significantly higher blood loss, operation time and hospitalization time compared to tumors < 5 cm. (p<0.05)Conclusion: Laparoscopic adrenalectomy is a safe and feasible technique. Transperitoneal approach would be more suitable technique for initial cases. Surgeons must consider the tumor size and possible pathology of adrenal tumor to decide the surgical technique.

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