Vincenzo Neri and Francesco Lapolla
Scientific Tracks Abstracts: Endocrinol Metab Synd
We evaluated the results of the up-to-dated literature and compared, in our experience, the results of the laparoscopic (LA) versus open (OA) approach in the treatment of the various kind of adrenal pathology. From 2000 to 2013 we treated 61 patients (33 female, 28 male; mean age 57, 2 bilateral adrenalectomies). We performed 33 LA with lateral transperitoneal approach (13 right; 20 left) and 28 anterior transperitoneal OA (16 right; 12 left). The pathologic features were: Cushing's syndrome (4), primary hyperaldosteronism (15), pheocromocytoma (14), lymphoma (1), non-functioning adrenal adenomas (29). Among the immediate results a greater blood loss was evident in the OA; whereas we had a rather longer operative time in LA. There were three conversions to a laparotomic procedure (4.9%). In the postoperative period there were some pulmonary infections (6) and infection of the laparotomy (3) in the OA; in the laparoscopic group there were two parietal hematomas that cleared up spontaneously, in correspondence of a trocar access. The size of the adrenal lesions for the LA is increased in the last years, but the standard indications are for lesions no more that 8-10 cm in size and confined within the gland. The morbidity in the mini-invasive approach is surely much lower than the open technique due to minor surgical stress. The evident datum that results from the literature analysis in the LA is the very rapid resumption of the normal activities in the postoperative course. In conclusion the laparoscopic adrenalectomy with lateral transperitoneal approach is a safe and efficacious procedure.
Vincenzo Neri graduated on 1970 in Medicine and Surgery in the University of Bari. He is Full Professor of General Surgery, University of Foggia, Department of Medical and Surgical Sciences. He is Director of the Division of General Surgery and Director of Residency School of General Surgery, University of Foggia. He is member of the following scientific associations: SIC, IHPBA, AISP, EASL, NESA, SLS. He is author of more than 330 scientific paper edited on national and international journals and chapters of books. His research interest is hepatobiliopancreatic surgery.
