ABSTRACT

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.

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.

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.

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.