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LAPAROSCOPIC MANAGEMENT OF SYMPTOMATIC AND LARGE ADRENAL CYSTS

2005; Lippincott Williams & Wilkins; Volume: 173; Issue: 3 Linguagem: Inglês

10.1097/01.ju.0000152177.35204.70

1527-3792

Octavio Castillo, Juan P. Litvak, M. Kerkebe, Rubén Ureña,

Adrenal Hormones and Disorders

No AccessJournal of UrologyAdult Urology: Physiology/Medical Disease/Adrenal1 Mar 2005LAPAROSCOPIC MANAGEMENT OF SYMPTOMATIC AND LARGE ADRENAL CYSTS OCTAVIO A. CASTILLO, JUAN P. LITVAK, MARCELO KERKEBE, and RUBEN D. URENA OCTAVIO A. CASTILLOOCTAVIO A. CASTILLO , JUAN P. LITVAKJUAN P. LITVAK , MARCELO KERKEBEMARCELO KERKEBE , and RUBEN D. URENARUBEN D. URENA View All Author Informationhttps://doi.org/10.1097/01.ju.0000152177.35204.70AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We present the feasibility and results of the laparoscopic management of symptomatic and large adrenal cysts. Materials and Methods: From June 1993 to April 2004 we performed 149 laparoscopic adrenalectomies. In this series 8 patients with symptomatic adrenal cysts or pseudocysts were treated laparoscopically. Surgical indications for laparoscopic management of adrenal cysts were abdominal pain in 5 cases and cyst size 5 cm or greater in 3. Results: The incidence of adrenal cyst was 5.4% (8 of 149 cases). Six patients underwent laparoscopic adrenal cyst decortication and marsupialization, 1 underwent laparoscopic partial adrenalectomy and 1 underwent laparoscopic adrenalectomy. Mean operative time was 77.5 minutes. There were no intraoperative or postoperative complications. Mean hospital stay was 1.7 days. At a mean followup of 18.5 months all patients were asymptomatic and without radiographic evidence of cyst recurrence. Conclusions: Laparoscopic conservative management of adrenal cysts is safe and feasible. Laparoscopic decortication and marsupialization should be the preferred treatment option for symptomatic adrenal cysts. Laparoscopic partial adrenalectomy or a total adrenalectomy can be performed in cases of larger cysts which compromise most of the adrenal gland. To our knowledge, this represents the largest series of symptomatic adrenal cysts managed laparoscopically. References 1 : Adrenal cysts. Am J Pathol1951; 27: 758. Google Scholar 2 : Adrenal cyst lesions: report of 12 surgically treated cases and review of the literature. J Endocrinol Invest1998; 21: 109. Google Scholar 3 : Hanson lecture. Adrenal imaging: current status. AJR Am J Roentgenol1990; 154: 927. Google Scholar 4 : The adrenals. In: . Philadelphia: W. B. Saunders Co.2002: 3507. sect. XIII, chapt. 101. Google Scholar 5 : Surgical management of adrenal cysts. Am Surg2003; 69: 812. Google Scholar 6 : Mesothelial cyst of the adrenal gland. Ann Pathol2000; 20: 235. Google Scholar 7 : Giant adrenal pseudocyst presenting with gastric outlet obstruction and hypertension. Urology2002; 59: 946. Google Scholar 8 : Imaging spectrum of adrenal pseudocysts on CT. Eur Radiol2003; 13: 531. Google Scholar 9 : Laparoscopic management of a giant adrenal cyst: case report. Surg Laparosc Endosc Percutan Tech2001; 11: 379. Google Scholar 10 : Cost-reductive retroperitoneal excision of large adrenal pseudocyst: a case report and review of the literature. Int Urol Nephrol2001; 33: 307. Google Scholar 11 : Laparoscopic unroofing of adrenal cysts. Eur Urol1997; 32: 499. Google Scholar 12 : Laparoscopic adrenal cyst resection. Tech Urol1998; 4: 202. Google Scholar 13 : Massive retroperitoneal hemorrhage owing to a ruptured adrenal cyst. J Urol1988; 139: 98. Link, Google Scholar 14 : Infected pseudocyst of adrenal gland. Case report. Eur J Surg1991; 157: 237. Google Scholar 15 : Management of adrenal cysts. Am Surg1999; 65: 151. Google Scholar 16 : Adrenal cysts and adrenal insufficiency in an infant with fatal termination. J Pediatr1950; 36: 91. Google Scholar 17 : Adrenal cysts: diagnosis and therapeutic approach. Int Surg1993; 78: 239. Google Scholar 18 : Adrenalectomía laparoscópica: resultados de una experiencia chilena inicial. Rev Med Chil1999; 127: 304. Google Scholar 19 : Cystic type adrenal mass. Clinical-radiologic contribution to 7 cases treated with surgery. Chir Ital2003; 55: 681. Google Scholar 20 : Morphology and pathogenesis of adrenal cysts. Am J Pathol1979; 95: 423. Google Scholar From the Section of Urology, Clinica Santa Maria (OAC, MK, RDU) and Department of Urology, Facultad de Medicina Oriente, Universidad de Chile (OAC), Santiago Chile, and Department of Urology, Boston Medical Center (JPL), Boston, Massachusetts© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 173Issue 3March 2005Page: 915-917 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordslaparoscopyadrenalectomyadrenal glandscystsMetrics Author Information OCTAVIO A. CASTILLO More articles by this author JUAN P. LITVAK More articles by this author MARCELO KERKEBE More articles by this author RUBEN D. URENA More articles by this author Expand All Advertisement PDF downloadLoading ...