Endoscopic Retroperitoneal Adrenalectomy for Adrenal Metastases

Abstract EN

Objectives.

To evaluate whether retroperitoneal approach for adrenalectomy is a safe and effective treatment for adrenal metastases (AM).

Methods.

From June 2004 to January 2014, nine consecutive patients with AM were treated with endoscopic retroperitoneal adrenalectomy (ERA).

A retrospective study was conducted, and clinical data, tumor characteristics, and oncologic outcomes were acquired and analyzed.

Results.

Renal cancer was the primary site of malignancy in 44.4% of cases.

The mean operative time was 132 ± 10.4 min.

There were 5 synchronous and 4 metachronous AM.

One patient required conversion to transperitoneal laparoscopic procedure.

No mortality or perioperative complications were observed.

The median overall survival was 11 months (range: 2–42 months).

Survival rates of 50% and 25% were identified at 1 and 3 years, respectively.

At the end of the study, 4 patients were alive with a mean observed follow-up of 20 months.

No patients presented with local tumor relapse or port-site metastases.

Conclusions.

This study shows that ERA is a safe and effective procedure for resection of AM and advances the surgical treatment of adrenal disease.

The use of the retroperitoneal approach for adrenal tumors less than 6 cm can provide very favorable surgical outcomes.