Results

A total of 18 adrenelectomies were conducted between July 2009 and May 2013. All but three were
conducted using a Laparoscopic Retroperitoneal approach. A Morrison’s approach was used for the
three above mentioned cases due to large tumour size (>7cm on CT).

Patient's Age
6

4
Frequency

0
0-29 30-39 40-49 50-59 60-69 70-79 80-89
Age (years)

Figure 1. Histogram of Patient’s age. The largest age group was between 50-59 years old with five
people. The next largest age groups were between 30-39 and 60-69, with four people in each group.
There were no patient’s under 30 years old and one person that was 80 years old.

Tumour Size
5
4
Frequency

3
2
1
0

Tumour Size (cm)

Figure 2. Histogram of tumour size. The largest tumour was 8.8 cm and the smallest was 1.2 cm. Size
was taken at the tumours greatest diameter. Tumour size was determined by either by CT or by
direct measurement of the gross tumour in theatre. Half of the tumours were between 2.1-5.0 cm.
 Percentage Conversion

13%

No
Yes

87%

Figure 3. Pie chart of percentage conversion rate. Two of 15 laparoscopic retroperitoneal

adrenelectomies were converted to open procedures. One was a 6 cm incidentaloma in a 51 year old
male and the other was a 5.8 cm pheochromocytoma in a 56 year old male. Both men were reported
to have heavy peri-nephric adipose and both tumours were of large size which resulted in a difficult
dissection.

Post-Operative Length of Stay

Morrison's
Incision

Laparoscopic Retroperitoneal

0 2 4 6 8 10 12 14
Length of stay (days)

Figure 4. Post-Operative Length of stay. Bar chart showing the average number of days patients
were in-patients post Adrenelectomy. Comparison was made between laparoscopic retroperitoneal
approach and open (Morrison’s) retroperitoneal approach.
Table 1. Post-Operative Complications. There were 6 immediate post-operative complications,
occurring while the patient was still an in-patient. These included: pneumonia, ileus, pneumothorax,
Post-operative nausea and vomiting (PONV), pulmonary embolus and difficult to control post-
operative pain requiring re-admission for analgesia. Uneventful represents when there were no in-
patient complications.

Post-Operative Total
Complications
Nosocomial Pneumonia 1
Paralytic ileus 1
Pneumothorax 1
PONV 1
Pulmonary embolus 1
Uneventful 11
Post-Operative pain 1
Grand Total 17

Table 2. Indication for surgery and subsequent histology.

INDICATION HISTOLOGY Total Cases

Hyperaldosteronism Adrenocortical Adenoma 2
Adrenocortical Hyperplasia 1

Hypertension Adrenocortical Adenoma 3

Adrenocortical Carcinoma 1

Incidentaloma Adrenocortical Adenoma 4

Medullary Haemangioma 1

Metastatic Metastatic Malignant 1

Melanoma Melanoma

Pheochromocytoma Pheochromocytoma 5