Laparoscopic adrenal surgery in children: Lessons from a single centre experience
Publication Type:Journal Article
Source:Journal of Minimal Access Surgery, Volume 7, Number 2, p.141-144 (2011)
Keywords:adolescent, adrenalectomy, article, bioassay, child, clinical article, clinical effectiveness, controlled study, Cushing disease, female, follow up, ganglioneuroma, hand assisted laparoscopy, human, human tissue, infant, laparoscopic surgery, length of stay, male, neuroblastoma, operation duration, outcome assessment, patient safety, patient selection, pediatric surgery, pheochromocytoma, preoperative evaluation, school child, surgical approach, tumor volume
Purpose: Although commonly performed in adults, laparoscopic adrenalectomy in children is performed only in centres with advanced laparoscopic expertise. Materials and Methods: This is a retrospective analysis of laparoscopic adrenalectomies performed at a single centre between January 2003 and May 2010. After preoperative evaluation with biochemical assays and radiologic imaging, surgery was performed by using the lateral transabdominal approach in all patients. Results: Ten laparoscopic adrenalectomies (including three bilateral) were performed in seven children, with a mean age of 9.6 years. The tumours ranged from 2 - 7 cms in size. The operative durations were 75 - 130 minutes (unilateral) and 250 - 270 minutes (bilateral). Operative blood loss was minimal. There were no open conversions, but terminal hand assistance was required in one large right pheochromocytoma. The postoperative hospital stay ranged from 3 - 10 days. The final pathological diagnoses included pheochromocytoma, hyperplasia and neuroblastoma. Follow-up at 24 - 87 months was uneventful. Conclusion: With adequate experience in laparoscopy, it is possible to perform adrenalectomy in selected children.
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