The minimally invasive technique has radically changed adrenal surgery since this type of procedure became the gold standard treatment for this pathology but comorbidities still define various limits for this type of surgery.
Method: In the past 6 years in General Surgery Department of Emergency Hospital Bucharest Romania over 150 laparoscopic adrenalectomies were performed, 21 of them for patients with associated thyroid pathology. This study group has 19 patients and we performed 20 unilateral laparoscopic adrenalectomyes (5 on the right side and 15 on the left side) and 1 bilateral laparoscopic adenalectomy. There were 11 patients with goitter, 6 with thyroid insufficiency, 1 autoimmune thyroiditis and 1 thyroidian autonomous nodule.
Results: In 21 operations were removed 22 adrenal glands with a diameter between 1 and 14 cm and next histopathologycal findings: hyperplasia – 13 (6 thyroid insufficiency, 7 goiter), adenoma – 7 (6 goiter and 1 autoimmune thyroiditis), pheocromocytoma – 2 (goiter and autonomous nodule). Preoperative preparation of patients was regularly concerning the thyroid disorder. Mean operative time was 82,54 min (20-180 min). We noticed 1 conversion to open surgery (not related to associated goiter) because of intraoperative arrhythmia due to manipulation of a large pheochromocytoma and one postoperative complication (reintervention for colonic fistulae). Postoperative hospital stay was 2 to 33 days.
Conclusions: For patients with adrenal pathology and endocrine comorbidities treated by laparoscopic surgery we noticed only few complications not related to associated diseases.
Program Number: P536