Laparoscopic adrenalectomy in children with diverse adrenal pathologies: the impact of pre-operative imaging in decision making process
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Dragan Kravarusic
Abstract
Objectives
The aim of this study was to assess the impact of pre-operative imaging regarding selecting cases of children’s who underwent laparoscopic adrenalectomy due to adrenal masses in two tertiary medical centers.
Methods
We performed a retrospective review of all laparoscopic adrenalectomy performed at two tertiary medical centers in Israel between 2017 and 2023.
Results
Sixteen (n=16) patients, 10 girls and six boys, underwent laparoscopic adrenalectomy through a transperitoneal approach. The median age was 10 years (range: eight months to 17.3 years). Six masses were incidentalomas. Preoperative imaging (ultrasonography, CT, and MRI) demonstrated a mass in the right adrenal (n=9) and left adrenal (n=7), with tumor sizes ranging from 1.8 to 5.3 cm in maximum diameter. Operative results showed minimal blood loss and no conversions to laparotomy. There were no postoperative complications. Pathological diagnoses included neuroblastoma (n=8), cortical hormone-secreting tumors (n=3), pheochromocytoma (n=2), adrenal cortical adenoma (n=2), and adrenal metastatic Ewing sarcoma (n=1). Eleven masses were defined as benign and five as malignant tumors.
Conclusions
Laparoscopic adrenalectomy appears to be a safe and effective technique in selected cases with adrenal masses. Among our cohort, malignant masses were more common compared to the predominantly benign adrenal masses seen in adults. Vascular encasement was a major factor in determining the feasibility of the laparoscopic approach, with preoperative imaging playing a critical role in this assessment.
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Research ethics: The study was conducted in accordance with the Declaration of Helsinki (RMC/2023).
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Informed consent: Not applicable.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Use of Large Language Models, AI and Machine Learning Tools: None declared.
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Conflict of interest: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: Not applicable.
References
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Articles in the same Issue
- Frontmatter
- Original Articles
- Effects of orlistat on body mass index and serum lipids in overweight and obese adolescents: a meta-analysis
- Psychological and behavioral assessments in girls with idiopathic central precocious puberty
- The effect of phlebotomy and placement of an intravenous catheter on plasma catecholamine and serum copeptin concentrations
- Laparoscopic adrenalectomy in children with diverse adrenal pathologies: the impact of pre-operative imaging in decision making process
- Short- to medium-term follow-up of normoponderal children and adolescents with subclinical hypothyroidism: a retrospective study of the last 15 years
- Newborn screening follow-up in Bavaria: height and weight in paediatric patients with congenital adrenal hyperplasia
- Patterns and determinants of serum amylase, lipase concentrations in Indian adolescents and youth with type 1 diabetes
- Pediatric Graves’ disease in Argentina: analyzing treatment strategies and outcomes
- Nephrogenic diabetes insipidus results from a novel in-frame deletion of AVPR2 gene in monozygotic-twin boys and their mother and grandmother
- Short Communication
- Does clonidine stimulate copeptin in children?
- Case Report and Review of the Literature
- Sialidosis type 1 in a Turkish family: a case report and review of literatures
- Case Reports
- Central precocious puberty in a toddler with hypothalamic hamartoma
- Autosomally dominantly inherited isolated gonadotropin deficiency via maternal assisted reproduction due to SOX10 mutation
- Unclear symptoms, early diagnosis and perfect outcome: a case diagnosed as sepiapterin reductase deficiency hidden behind vitamin B12 deficiency
