Murat Tolga GÜLPINAR, Asıf YILDIRIM, Cenk GÜRBÜZ, İbrahim Ali ÖZDEMİR, Ramazan Gökhan ATIŞ, Özgür EFİLOĞLU, BÜLENT EROL, Rafet YİĞİTBAŞI, Turhan ÇAŞKURLU

Transperitoneal laparoskopik adrenalektomi: İlk 35 olgunun sonuçları ve öğrendiklerimiz

Amaç: Adrenal kitlelerin tedavisinde uyguladığımız laparoskopik girişimlerin 5 yıllık laparoscopic adrenalectomies performed over a sonuçları değerlendirildi.5-year period.Gereç ve Yöntem: Bu tanımsal, retrospektif ve gözlemsel çalışmada Ocak 2009 ve Mayıs 2014 tarihleri arasında transperitoneal laparoskopik adrenalektomi uygulanan 35 hastanın patients sex, age, preoperative diagnosis, size cinsiyet, yaş, preoperatif tanı, kitle boyutu, kitand laterality of mass, operative times, conversile tarafı, operasyon süresi, açık cerrahiye geçiş oranı, postoperatif komplikasyon, hastanede length of hospital stay and the results of histokalış süresi ve histopatolojik sonuçlar değerpathological examination, between January 2009 lendirildi. Ocak 2009 ve Mayıs 2014 tarihleri and May 2014.arasında 35 transperitoneal laparoskopik adrenalektomi uygulandı.Bulgular: Hastaların ortalama yaşı 50,2 sis of lesions were 15 adrenocortical adenomas 42.8% , 10 pheochromocytomas 28.5% , 1 lei ±3,5 yıldı. Kitlelerin patolojik tanıları 15 adrenokortikal adenom %42,8 , 10 feokromasitoma %28,5 , 1 leyomiyosarkom %2,8 , 1 noma infiltration 2.8% , 1 cystic lymphangioma miyolipom %2,8 , 1 anjiomiyolipom %2,8 , 1 2.8% , 1 miyolipom 2.8% , 1 angiomyolipoma kavernöz hemanjiyom %2,8 , 1 hemorajik kist %2,8 , 1 mezenterik kist %2,8 , 1 pseudokist %2,8 , 1 endotelyal vasküler kist %2,8 1 küçük hücreli akciğer kanseri metastazı %2,8 ve 1 kistik lenfanjioma %2,8 olarak rapor edildi. Açık cerrahiye geçilen 5 hastanın 4’ü kanamaya, bir tanesi ise yaygın yapışıklığa bağlı idi.Sonuç: Laparoskopik transperitoneal adrenalektomi benign adrenal tümörlerde altın standart tedavidir ve iyi seçilmiş malign tümörler için de uygun bir tedavi seçeneğidir

Anahtar Kelimeler:

Adrenal kitle, laparoskopik adrenalektomi

Transperitoneal laparoscopic adrenalectomy: Outcomes and lessons learned from initial 35 cases

Objective: We analyzed the outcomes of laparoscopic adrenalectomies performed over a 5-year period. Material and Method: In this descriptive, retrospective, observational study, we analyzed 35 laparoscopic transperitoneal adrenalectomy patients sex, age, preoperative diagnosis, size and laterality of mass, operative times, conversion to open surgery, postoperative complications, length of hospital stay and the results of histopathological examination, between January 2009 and May 2014. Results: The average age of patients was 50.2 ±3.5 years old. The pathologic diagnosis of lesions were 15 adrenocortical adenomas 42.8% , 10 pheochromocytomas 28.5% , 1 leiomyosarcoma 2.8% , 1 small cell adenoid carcinoma infiltration 2.8% , 1 cystic lymphangioma 2.8% , 1 miyolipom 2.8% , 1 angiomyolipoma 2.8% , 1 cavernous hemangioma 2.8% , 1 hemorrhagic cyst 2.8% , 1 mesenteric cyst 2.8% , 1 pseudocyst 2.8% , 1 endothelial vascular cyst 2.8% , 1 small cell lung cancer metastasis %2.8 and 1 cystic lymphangioma %2.8 . 5 14.2% cases required conversion to open surgery because of bleeding 4 cases and extensive fibrosis 1 case . Conclusion: Laparoscopic transperitoneal adrenalectomy has proved to be gold standard in the not only treatment of benign adrenal tumors and also alternative treatment for well-selected adrenal malignant tumors.

Keywords:

Adrenal mass, laparoscopic adrenalectomy,

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