Retroperitoneal laparoscopic decortication and adrenalectomy for the therapy of adrenal cysts

Objective: To summarize the clinical characteristics of adrenal cysts and compare the therapeutic results of two different laparoscopic surgical techniques.

Methods: Sixteen patients of adrenal cysts were summarized retrospectively from May 2005 to June 2012. Their clinical manifestations, pathological features, therapeutic effects and prognosis were analyzed. There were 7 males and 9 females aged 39.4 (25-68) years.Eight patients were symptomatic and the others were identified incidentally. They underwent laparoscopic surgery through retroperitoneal space, including adrenalectomy (n = 11) and decortication (n = 5).

Results: All were confirmed as adrenal cysts by postoperative pathological examination.It accounted for around 7.5% of adrenal disease treated surgically at our department cutaneous. The diagnostic accuracy of computed tomography and magnetic resonance imaging was 11/16 and 3/3 respectively. The mean diameter of cyst was 5.3 (1-14) cm and no apparent endocrine abnormalities were found. The symptoms of 7/8 patients were relieved after a mean 48 months follow-up.No recurrence was found in this cohort. The average operative duration and estimated volume of blood loss were significantly less in laparoscopic decortication group ( (48 ± 10) min, (16 ± 11) ml) than laparoscopic adrenalectomy group ((74 ± 21) min, (34 ± 30) ml) .

Conclusions: Laparoscopic surgery is an effective procedure for the treatment of adrenal cysts. And retroperitoneal laparoscopic decortication may be preferred treatment option for large benign adrenal cysts.