Background: Laparoscopic adrenalectomy is still controversial in cases where malignancy is suspected. However,\nmany proponents of this technique argue that in the hands of an experienced surgeon, laparoscopy can be safely\nperformed. The aim of this study is to present our own experience with the application of laparoscopic surgery for\nthe treatment of malignant and potentially malignant adrenal tumours.\nMethods: Our analysis included 52 patients who underwent laparoscopic adrenalectomy in 2003ââ?¬â??2014 due to a\nmalignant or potentially malignant adrenal tumour. Inclusion criteria were primary adrenal malignancy, adrenal\nmetastasis or pheochromocytoma with a PASS score greater than 6. We analyzed the conversion rate, intra- and\npostoperative complications, intraoperative blood loss and R0 resection rate. Survival was estimated using the\nKaplan-Meier method.\nResults: Conversion was necessary in 5 (9.7 %) cases. Complications occurred in a total of 6 patients (11.5 %).\nR0 resection was achieved in 41 (78.8 %) patients and R1 resection in 9 (17.3 %) patients. In 2 (3.9 %) cases R2\nresection was performed. The mean follow-up time was 32.9 months. Survival depended on the type of tumour\nand was comparable with survival after open adrenalectomy presented in other studies.\nConclusions: We consider that laparoscopic surgery for adrenal malignancy can be an equal alternative to open\nsurgery and in the hand of an experienced surgeon it guarantees the possibility of noninferiority. Additionally,\nstarting a procedure with laparoscopy allows for minimally invasive evaluation of peritoneal cavity. The key element\nin surgery for any malignancy is not the surgical access itself but the proper technique.
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