Analysis of feasibility and safety of retroperitoneal laparoscopic adrenalectomy for children with adrenal tumors

Abstract

Objective To investigate the feasibility and safety of retroperitoneal laparoscopic adrenalectomy for children with adrenal tumors. Methods Clinical data of 15 children (8 males and 7 males) with adrenal tumors who underwent laparoscopic adrenalectomy were retrospectively analyzed.The age ranged from 2 months to 13 years, with the median age of 3 years. There were 7 sinister and 8 dextral tumors with the average diameter at 4.9 cm ranging from 1.4 to 13 cm. Results Complete laparoscopic procedure was perform on all eases except 1 patient underwent conversion to open surgery due to extremely large size of the tumor. Mean operation time for laparoscopic procedure was 70 minutes ranging from 39 to 125 minutes. Mean blood loss during operation was 56 ml ranging from 30 to 120 ml. Intraoperative blood pressure fluctuation was noted in 1 patient with pheochromocytoma. One patient complicated with postoperative retroperitoneal hematoma which was absorbed 1 day later. The other one suffered subcutaneous emphysema which was absorbed 5 days later. Length of hospital stay was from 6 to 7 days with the average of 6. 3 days. Pathological diagnosis showed that 7 cases were adrenal neuroblastoma, 5 as ganglioma, 1 as ganglioblastoma, 1 as cortical adenoma, and the other 1 as pheochromocytoma. Patients with malignant tumors who were treated with chemotherapy were followed up for 6 to 13 months, all of whom were alive without recurrence. Conclusions Retroperitoneal laparoscopic adrenalectomy for children with adrenal tumors is a feasible, safe and minimally invasive procedure. Patients can have shorter length of stay and less surgical scar. The retroperitoneal laparoscopic adrenalectomy might become the primary alternative for patients with benign tumors or tumors with relatively smaller size. Some malignant adrenal tumors with small size or regular boundary can also be an indication for the laparoscopic procedure. Key words: Adrenal gland neoplasms; Adrenalectomy