Laparoscopic adrenalectomy for malignant disease - Technical feasibility and oncological results Supra-renalectomia laparoscópica para doença maligna - Factibilidade técnica e resultados oncológicos

Objective: Laparoscopic resection is the gold standard for treatment of benign adrenal lesions. Laparoscopic resection of malignant lesions, however, is controversial, and there are only limited series published in the literature. The aim of this study is to describe technical aspects and oncological results of laparoscopic adrenalectomy for malignant disease. Methods: Eight patients (five men and three women) underwent laparoscopic adrenalectomy for primary or metastatic adrenal malignancy. The procedures were performed transperitoneally in two cases and retroperitoneally in 6 cases. results: The mean incision size was 5 cm (4-9 cm), the mean duration of surgery was 135 minutes and the mean blood loss was 250 ml. There was one case of postoperative pneumonia, which progressed favorably. Histopathological diagnosis was metastasis in four cases and primary adrenal neoplasm in four cases. There were two cases of systemic recurrence in patients with metastatic adrenal cancer which originated from breast-cancer in one case and lung cancer in another case. Local recurrence or implantations on the trocar sites were not observed. All patients with primary adrenal neoplasms and 50% of those with metastatic lesions of the adrenal were alive at the end of the follow-up period. Conclusion : Treatment of adrenal malignant disease can be safely performed through videolaparoscopy in patients with primary adenocarcinoma or adrenal gland metastasis. The prognosis depends on resectability and biological aggressiveness of the disease.