The Clinical, Oncological, Functional and Surgical Outcomes of Patients Who Underwent Adrenalectomy
Journal Title: Üroonkoloji Bülteni - Year 2016, Vol 15, Issue 4
Abstract
Objective: Adrenal masses are often benign and rarely malignant. They may be also hormonally functional or non-functional. It is possible to treat these masses curatively with open and laparoscopic adrenalectomy. The aim of this study is to analyse the clinical, functional, oncological and surgical outcomes of patients who underwent adrenalectomy in our clinic. Materials and Methods: A total of 88 files of patients patient, who underwent open and laparoscopic adrenalectomy between January 2005 and June 2015 in Urology Clinic of Gazi University, were evaluated retrospectively. Patients were evaluated in terms of their age, gender, radiological diagnostic techniques, initial symptoms and laboratory findings of serum and urine. The data of mass sizes, operation types, histopathological results of excised masses, body-mass index (BMI), American Society of Anesthesiologists (ASA) physical status classification score, bleeding amounts, the duration of operation and hospitalization, perioperative complications and blood transfusion rates of patients were recorded. The relationship between these parameters both in patients with functional and non-functional masses and in patients with benign and malignant masses were statistically evaluated. Results: A total of 88 patients with adrenal masses were endocrinologically evaluated. Fifty nine (67%) patients had functional masses and 29 (33%) patients had non-functional masses. Open transabdominal adrenalectomy and laparoscopic adrenalectomy were performed in 20 (22.7%) and 68 (77.3%) patients, respectively. According to the results of histopathological evaluation, benign and malignant masses were determined in 79 (89.7%) and nine (10.3%) patients, respectively. Bleeding amount and mass size were significantly higher in patients with malignant masses and in patients with functional masses (p=0.003 and p=0.002; p=0.007 and p=0.004, respectively). The duration of operation and hospitalization were significantly longer, and peri-operative complication and blood transfusion rates were significantly higher in patients with malignant masses (p=0.006 and p=0.003; p=0.027 and p=0.001, respectively). Neither functionality nor pathology of adrenal masses had a statistically significant relationship with ASA score and BMI. Conclusion: Hormonal assessment is certainly required in patients with adrenal masses. The decision of surgical method should be based on tumor size of the patient, and as well as the presence of malignancy and concomitant comorbities.
Authors and Affiliations
Ünsal Eroğlu, Murat Yavuz Koparal, İyimser Üre, Serhat Çetin, Ender Cem Bulut, Cenk Acar, Tevfik Sinan Sözen
Robotic-assisted Laparoscopic Prostatectomy: Initial Experience of 267 Cases
Objective: To present our experience of 267 consecutive patients treated with robotic-assisted laparoscopic prostatectomy (RALP) and assess the perioperative and postoperative outcomes. Materials and Methods: Materials a...
Long-Term Outcomes of Patients Who Underwent Ureterocutaneostomy
Objective: Ureterocutaneostomy (UCS) is a urinary diversion (UD) method which is used rarely in a carefully selected patient group. In this study, we aimed to present the data and long-term outcomes of patients who under...
Contemporary Trends in Adjuvant and Neoadjuvant Treatment for Renal Cell Carcinoma
Renal cell carcinoma is an increasingly significant cancer in which surgical resection is still the sole curative approach. There is a risk of recurrence in one-third of patients after surgery. Successful experiences wit...
Vascular Endothelial Growth Factor and Thrombospondin-1 mRNA Expression in Bladder Tumors: Correlation with Histopathology and Prognosis
Objective: The purpose of this study was to determine genetic expression levels of vascular endothelial growth factor (VEGF) and thrombospondin-1 (TSP-1) in fresh bladder tumor specimens and evaluate their relationship w...
Should We Perform Thoracic Imaging for Every Patient with a Renal Mass?
Objective: Current guidelines for the management of renal mass recommend thoracic imaging for potential metastatic nodules. Small size of the renal mass can be associated with low metastatic potential, which might questi...