Ces Urol 2024, 28(3):166-173 | DOI: 10.48095/cccu2024027

Laparoscopic adrenalectomy in childhood

Marcela Pýchová¹, Štěpán Veselý², Luboš Zeman¹, Marek Schmidt²

¹ Klinika dětské chirurgie, 2. LF UK a FN Motol, Praha

² Urologická klinika, 2. LF UK a FN Motol, Praha

Pýchová M, Veselý Š, Zeman L, Schmidt M. Laparoscopic adrenalectomy in childhood.

Aim: The aim of this retrospective study is to evaluate the results of laparoscopic adrenalectomies in pediatric patients. Laparoscopic adrenalectomy in children is rarely indicated, most often for benign lesions, pheochromocytomas, or small circumscribed neurogenic tumors.

Materials and methods: Patients who underwent transperitoneal laparoscopic adrenalectomy between 2012 to 2023 were included in this retrospective study. The data were obtained from the electronic medical records of Motol university hospital.

Results: Fourteen laparoscopic adrenalectomies were performed (9 right, 5 left) in 13 patients (8 girls and 5 boys) with an average age of 14.6 years (11-17 years). The mean tumor size was 45 mm (20-106 mm). The average operation time was 109 minutes (53-231 min), and the average blood loss was 30 ml (0-300 ml). A correlation between the size of the tumor and the time of surgery was statistically proven. There were no postoperative complications classified as Clavien-Dindo grade III or higher. All tumors were removed radically without capsule rupture and no procedures required conversion. Histological analysis revealed pheochromocytoma (6 patients, 43%), ganglioneuroma (4 patients, 29%), adenoma (2 patients, 14%), adenocarcinoma (1 patient, 7%), and adrenal pseudocyst (1 patient, 7%). The mean hospital length of stay was 4.6 days (4-6 days). One patient with a malignant disease died. The average follow-up period was 5.7 years (3 months-11 years).

Conclusion: Laparoscopic adrenalectomy in children is a safe procedure. The benefits of this technique include a minimally invasive approach, minimal blood loss, and a short hospital stay.

Keywords: Laparoscopic adrenalectomy, children, tumor.

Received: July 11, 2024; Accepted: September 9, 2024; Published: October 1, 2024