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Effect of Laparoscopy on the Indications for Adrenalectomy
Daniel Henneman, BSc;
Yuchiao Chang, PhD;
Richard A. Hodin, MD;
David L. Berger, MD
Arch Surg. 2009;144(3):255-259.
Background Laparoscopic adrenalectomy is now the criterion standard for removal of most benign adrenal lesions and may be used for malignant lesions as well. At the same time, improved imaging has led to an increase in the number of incidentally detected adrenal masses. The aim of this study was to determine whether the introduction of laparoscopy has changed the indications for adrenalectomy.
Design Retrospective cohort study of patients operated on for primary adrenal disease between September 1, 1987, and August 17, 2007.
Setting Academic hospital.
Patients Sixty-six patients treated before (group 1) and 203 treated after (group 2) introduction of laparoscopic adrenalectomy.
Main Outcome Measures Patient characteristics, comorbidity, tumor size, indication, and time between diagnosis and surgery.
Results Group 2 had more patients in American Society of Anesthesiologists class III with gastrointestinal and metabolic-endocrine comorbidities. Tumor size did not change, and, despite an increase in the number of adrenalectomies, indications for surgery remained consistent over time.
Conclusion Despite an increased volume of procedures, the introduction of laparoscopic adrenalectomy in our hospital did not change the indications for surgical intervention.
Author Affiliations: University of Amsterdam, Amsterdam, the Netherlands (Mr Henneman) and Department of General Surgery, Massachusetts General Hospital, Boston (Drs Chang, Hodin, and Berger).
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Effect of Laparoscopy on the Indications for Adrenalectomy—Invited Critique
Richard A. Prinz and G. Scott Smith
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