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Open Adrenalectomy

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Surgery of the Adrenal Gland

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Abstract

In all the centres of endocrine surgery, laparoscopic adrenalectomy is now considered the gold standard to treat adrenal pathology. Nevertheless, for decades open adrenalectomy has been the only surgical approach to adrenal diseases and still remains, with limited indication, a possible technique in case of contraindication to laparoscopy or when specific features of the adrenal tumor require wider access and safer procedure control by an open technique. General indications to an elective open approach are: large lesions (above 12 cm in maximum diameter), malignant or recurrent tumors, bilateral diseases, general or specific contraindications to laparoscopy, and extra-adrenal pheochromocytomas. Open surgery is classified considering the different possible accesses in: transperitoneal (anterior trans-abdominal including: median, transverse, subcostal), extrapleural-extraperitoneal (lateral, posterior), and transpleural-transdiafragmatic (trans-toraco-abdominal or thoracolaparotomy). Emergency laparotomy during laparoscopy might be due to: intraoperative haemorrhage, difficult anatomy, suspicion of malignancy during laparoscopy, and difficulty to perform a radical resection by laparoscopy. The most important advantages compared to the minimally invasive approach might be related to a safer vascular control and to a radical treatment of invasive tumors by en bloc resection of the invaded organs.

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References

  1. Greco F, Hoda MR, Rassweiler J, Fahlenkamp D, Neisius DA, Kutta A, Thüroff JW, Krause A, Strohmaier WL, Bachmann A, Hertle L, Popken G, Deger S, Doehn C, Jocham D, Loch T, Lahme S, Janitzky V, Gilfrich CP, Klotz T, Kopper B, Rebmann U, Kälbe T, Wetterauer U, Leitenberger A, Raßler J, Kawan F, Inferrera A, Wagner S, Fornara P (2011) Laparoscopic adrenalectomy in urological centres—the experience of the German Laparoscopic Working Group. BJU Int. 108(10):1646–1651

    Google Scholar 

  2. Rieder JM, Nisbet AA, Wuerstle MC, Tran VQ, Kwon EO, Chien GW (2010) Differences in left and right laparoscopic adrenalectomy. JSLS 14:369–373

    Article  PubMed  Google Scholar 

  3. Zografos GN, Farfaras A, Vasiliadis G, Pappa T, Aggeli C, Vasilatou E, Kaltsas G, Piaditis G (2010) Laparoscopic resection of large adrenal tumors. JSLS 14:364–368

    Article  PubMed  Google Scholar 

  4. Shen WT, Grogan R, Vriens M, Clark OH, Duh QY (2010) One hundred two patients with pheochromocytoma treated at a single institution since the introduction of laparoscopic adrenalectomy. Arch Surg 145:893–897

    Article  PubMed  Google Scholar 

  5. Gupta PK, Natarajan B, Pallati PK, Gupta H, Sainath J, Fitzgibbons RJ Jr (2011) Outcomes after laparoscopic adrenalectomy. Surg Endosc 25:784–794

    Article  PubMed  Google Scholar 

  6. Brix D, Allolio B, Fenske W, Agha A, Dralle H, Jurowich C, Langer P, Mussack T, Nies C, Riedmiller H, Spahn M, Weismann D, Hahner S (2010) German adrenocortical carcinoma registry group. Laparoscopic versus open adrenalectomy for adrenocortical carcinoma: surgical and oncologic outcome in 152 patients. Eur Urol 58:609–615

    Article  PubMed  Google Scholar 

  7. Mazzaglia PJ, Vezeridis MP (2010) Laparoscopic adrenalectomy: balancing the operative indications with the technical advances. J Surg Oncol 15(101):739–744

    Article  Google Scholar 

  8. Conzo G, Tricarico A, Belli G, Candela S, Corcione F, Del Genio G, Ferulano GP, Giardiello C, Livrea A, Marzano LA, Porcelli A, Sperlongano P, Vincenti R, Palazzo A, De Martino C, Musella M (2009) Adrenal incidentalomas in the laparoscopic era and the role of correct surgical indications: observations from 255 consecutive adrenalectomies in an Italian series. Can J Surg 52:281–285

    Google Scholar 

  9. Kawabata G, Shimogaki H, Yamanaka K, Matsushita K, Takechi Y (2009) Laparoscopic adrenalectomy: troublesome cases. Int J Urol 16:431

    Article  PubMed  Google Scholar 

  10. Boylu U, Oommen M, Lee BR, Thomas R (2009) Laparoscopic adrenalectomy for large adrenal masses: pushing the envelope. J Endourol 23:971–975

    Article  PubMed  Google Scholar 

  11. Erbil Y, Barbaros U, Karaman G, Bozbora A, Ozarmağan S (2009) The change in the principle of performing laparoscopic adrenalectomy from small to large masses. Int J Surg 7:266–271

    Article  PubMed  Google Scholar 

  12. Tanaka M, Ono Y, Matsuda T, Terachi T, Suzuki K, Baba S, Hara I; Urological Laparoscopic Surgery Guideline Committee, Japanese Society of Endourology and ESWL (2009) Guidelines for urological laparoscopic surgery. Int J Urol 16:115–125

    Article  PubMed  Google Scholar 

  13. Gonzales RJ, Shapiro S, Sarlis N et al (2005) Laparoscopic resection of adrenal cortical carcinoma: a cautionary note. Surgery 138:1078–1085

    Article  Google Scholar 

  14. Prager G, Heinz-Peer G, Passler C et al (2004) Applicability of laparoscopic adrenalectomy in a prospective study in 150 consecutive patients. Arch Surg 139:46–49

    Article  PubMed  Google Scholar 

  15. Lezoche E, Guerrieri M, Paganini AM et al (2000) Laparoscopic adrenalectomy by the anterior transperitoneal approach: results of 108 operations in unselected cases. Surg Endosc 14:920–925

    Article  CAS  PubMed  Google Scholar 

  16. Dickson PV, Jimenez C, Chisholm GB, Kennamer DL, Ng C, Grubbs EG, Evans DB, Lee JE, Perrier ND (2011) Posterior retroperitoneoscopic adrenalectomy: a contemporary american experience. J Am Coll Surg 212:659–665

    Article  PubMed  Google Scholar 

  17. Li QY, Li F (2010) Laparoscopic adrenalectomy in pheochromocytoma: retroperitoneal approach versus transperitoneal approach. J Endourol 24:1441–1445

    Article  PubMed  Google Scholar 

  18. Branco AW, Kondo W, Stunitz LC, Neto SR, Nascimento CC, Filho AJ (2010) Adrenalectomy by retroperitoneal laparoendoscopic single site surgery. JSLS 14:571–575

    Article  PubMed  Google Scholar 

  19. Berber E, Tellioglu G, Harvey A, Mitchell J, Milas M, Siperstein A (2009) Comparison of laparoscopic transabdominal lateral versus posterior retroperitoneal adrenalectomy. Surgery 146:621–625

    Article  PubMed  Google Scholar 

  20. Walz MK, Peitgen K, Diesing D et al (2004) Partial versus total adrenalectomy by the posterior retroperitoneoscopic approach: early and long-term results of 325 consecutive procedures in primary adrenal neoplasias. World J Surg 28:1323–1329

    Article  PubMed  Google Scholar 

  21. Miccoli P, Raffaelli M, Berti P et al (2002) Adrenal surgery before and after the introduction of laparoscopic adrenalectomy. Br J Surg 89:779–782

    Article  CAS  Google Scholar 

  22. Polistena A, D’Angeli L, Cavallaro G, Izzo L, Cotesta D, Petramala L, Letizia C, Cavallaro G, De Toma G (2009) Surgical treatment of extra-adrenal abdominal paragangliomas. Am Surg 75:1153–1155

    PubMed  Google Scholar 

  23. Mellon MJ, Sundaram CP (2008) Laparoscopic adrenalectomy for pheochromocytoma versus other surgical indications. JSLS 12:380–384

    PubMed  Google Scholar 

  24. Gumbs A, Gagner M (2006) Laparoscopic adrenalectomy. Best Pract Res Clin Endocrinol Metabol 20:483–499

    Article  Google Scholar 

  25. Petramala L, Cavallaro G, Polistena A, Cotesta D, Verrienti A, Ciardi A, Lucia P, Filetti S, D’Erasmo E, De Toma G, Letizia C (2008) Multiple catecholamine-secreting paragangliomas: diagnosis after hemorrhagic stroke in a young woman. Endocr Pract 14(3):340–346

    PubMed  Google Scholar 

  26. Zhang X, Wang B, Ma X, Zhang G, Shi T, Ju Z, Wang C, Li H, Ai X, Fu B (2009) Laparoscopic adrenalectomy for beginners without open counterpart experience: initial results under staged training. Urology 73:1061–1065

    Article  PubMed  Google Scholar 

  27. Dudley NE, Harrison BJ (1999) Comparison of open posterior versus transperitoneal laparoscopic adrenalectomy. Br J of Surg 86:656–660

    Article  CAS  PubMed  Google Scholar 

  28. Prinz RA (1995) A comparison of laparoscopic and open adrenalectomies. Arch Surg 130:489–492

    Article  CAS  PubMed  Google Scholar 

  29. Barreca M, Presenti L, De Toma G, Valeri A, Cavallaro G, Borrelli A, Stipa F, Borrelli D, Cavallaro A (2003) Expectations and outcome when moving from open to laparoscopic adrenalectomy: multivariate analysis. World J Surg 27:223–228

    PubMed  Google Scholar 

  30. Cavallaro G, Letizia C, Polistena A, De Toma G (2011) Laparoscopic adrenal-sparing surgery: personal experience, review on technical aspects. Updates Surg 63:35–38

    Article  PubMed  Google Scholar 

  31. Shen WT, Kebebew E, Clark OH, Duh QY (2004) Reasons for conversion from laparoscopic to open or hand assisted adrenalectomies from 1993 to 2003. World J Surg 2004(28):1176–1179

    Article  Google Scholar 

  32. De Toma G, Letizia C, Cavallaro G, Gioacchino V, Mosiello G, Cavallaro A, Basile U (2002) Malignant pheochromocytoma. Personal experience, review of the literature. Ann Ital Chir 73(4):413–418

    PubMed  Google Scholar 

  33. Rosato L et al (2008) Trattato Italiano di Endocrinochirurgia. Club delle UEC, Ivrea, Italy

    Google Scholar 

  34. Valeri A, Bergamini C (2007) I tumori del Surrene. Guida alla diagnosi e alla terapia, SEE, Firenze, Italy

    Google Scholar 

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Authors and Affiliations

  1. Department of Surgery “Pietro Valdoni”, “Umberto I” University Hospital, University of Rome “La Sapienza”, Viale del Policlinico 155, 00161, Rome, Italy

    Giorgio De Toma, Andrea Polistena & Giuseppe Cavallaro

Authors
  1. Giorgio De Toma
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  2. Andrea Polistena
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  3. Giuseppe Cavallaro
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Correspondence to Giorgio De Toma .

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Editors and Affiliations

  1. , Chirurgia Generale, d'Urgenza e Mini-inv, Ospedale Careggi, Largo Brambilla 3, Florence, 50134, Italy

    Andrea Valeri

  2. , Chirurgia Generale, d'Urgenza e Mini-inv, Ospedale Careggi, Largo Brambilla 3, Florence, 50134, Italy

    Carlo Bergamini

  3. , Istituto di Semeiotica Chirurgica, Policlinico Gemelli, Largo Agostino Gemelli 8, Rome, 00168, Italy

    Rocco Bellantone

  4. , Istituto di Semeiotica Chirurgica, Policlinico Gemelli, Largo Agostino Gemelli 8, Rome, 00168, Italy

    Celestino Pio Lombardi

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De Toma, G., Polistena, A., Cavallaro, G. (2013). Open Adrenalectomy. In: Valeri, A., Bergamini, C., Bellantone, R., Lombardi, C. (eds) Surgery of the Adrenal Gland. Springer, Milano. https://doi.org/10.1007/978-88-470-2586-8_12

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  • DOI: https://doi.org/10.1007/978-88-470-2586-8_12

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2585-1

  • Online ISBN: 978-88-470-2586-8

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