The Effect of Hormone Activity and Malignancy on Surgical Parameters in Laparoscopic Adrenalectomy

Abstract

Tumours of the adrenal gland can be encountered in various forms ranging from non-hormone-secreting benign adenomas to hormone-secreting malignant adrenocortical carcinomas. This study aimed to investigate the effect of hormone-functional tumours, malignant pathological results and tumour size on surgical and clinical parameters in patients undergoing laparoscopic transperitoneal adrenalectomy. A total of 63 patients who underwent transperitoneal laparoscopic adrenalectomy were included in this study. In the first stage of the study, two groups were formed as hormone-functional adrenal tumours and hormone-non-functional adrenal tumours. In the second stage of the study, the patients were histopathologically divided into 2 groups as malignant and benign adrenal tumours. The effects of hormone activity and malignancy on surgical parameters were investigated in both stages. Mean duration of operation and intraoperative blood loss were higher in the group with malignant pathology (p=0.041, p=0.014, respectively). The duration of operation was shorter in Conn's syndrome compared to the Cushing's syndrome and pheochromocytoma groups (p=0.038). There was a moderate positive correlation between pathological tumour size and duration of operation, which was statistically significant (r=0.449, p<0.001). The success of laparoscopic adrenalectomy is affected by the morphological and functional characteristics of the mass. Prolonged operation times and increased bleeding have been observed in malignant masses. It is esential for surgeons performing the operation to be aware that they may encounter varying clinical presentations both during and after the procedure, depending on the morphological and functional characteristics of the mass.