1. Outcomes following laparoscopic adrenalectomy: Experience of more than two decades at a tertiary care centre
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Bansal, Virinder Kumar, Asuri, Krishna, Singh, Deepti, Agarwal, Keshav, Dixit, Raghunandan, Prakash, Om, Kumar, Subodh, Subramaniam, Rajeshwari, Ramachandran, Rashmi, Tandon, Nikhil, and Misra, M. C.
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Health aspects ,Laparoscopy -- Health aspects ,Laparoscopic surgery -- Health aspects - Abstract
Author(s): Virinder Kumar Bansal (corresponding author) [1]; Krishna Asuri [1]; Deepti Singh [1]; Keshav Agarwal [2]; Raghunandan Dixit [1]; Om Prakash [1]; Subodh Kumar [1]; Rajeshwari Subramaniam [3]; Rashmi Ramachandran [...], Introduction: Laparoscopic transperitoneal adrenalectomy was first described by Gagner M et al. Here, we present our experience of more than two decades of laparoscopic adrenalectomy performed in a single surgical unit at a tertiary care centre. Patients and Methods: A prospectively collected database of patients undergoing laparoscopic adrenalectomy from December 1994 to May 2020 was analysed retrospectively. The demographic profile, details of clinical workup and laboratory parameters were recorded in a pre-structured pro forma. Functional workup and anatomical imaging were performed for all the patients. Patients were taken up for surgery after adequate pre-operative optimisation using a multidisciplinary approach. All the patients were operated by a single surgical team of experienced laparoscopic surgeons. Results: A total of 158 patients underwent laparoscopic transperitoneal adrenalectomy. The majority patients were females (64.5). The median tumour size was 5 cm (range, 1-18 cm). The diagnosis in the majority of the patients was pheochromocytoma (56.3). The mean operative time was 80 min (range: 45-210 min). The most common complication was bleeding in 6 (3.7) patients, which required laparotomy. The median duration of post-operative hospital stay was 3 days (range: 1-13). There was no 30-day mortality. The mean follow-up period was 15 months (range: 6-72 months), during which two patients developed local recurrence. Conclusion: The advantages of laparoscopic surgery are well established and have been extensively explored for the management of adrenal lesions. A multidisciplinary approach to management, consisting of endocrinologists, surgeons and anaesthesiologists is preferred. Pre-operative evaluation, optimisation and accurate selection of patients are crucial for successful laparoscopic adrenalectomy. Keywords: Adrenalectomy, laparoscopic, pheochromocytoma
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- 2025
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