| Objective:To conclude the clinical feature of bilateral primary adrenal tumor, and to explore diagnosis and Minimaly Invasive Surgery treatment methods.Methods:This study includes21cases of bilateral adrenal tumor treated in Minimally Invasive Urology Center of Shandong Provincial Hospital affiliated to Shandong University between December2010and October2012. Their diagnosis were based on clinical symptoms, signs, laboratory examinations, and imaging examininations. Cases which Preoperative imaging highly suspect or postoperative pathological examinations indicated bilateral nodular adrenal hyperplasia (BNAH) were excluded. In21cases,8were male,13were female. Functional tumor15cases, in which4were catecholamine syndrome type,6were hyperaldosteronism type,3were hypercortisolism type,2cases had both elevated hormonal indexes.6cases were nonfunctional tumor. To all these cases, apply retrospective analysis.Results:All patients underwent laparoscopic adrenoectomy. Pathology examinations show among21cases, In functional tumor group,5were bilateral adrenal pheochromocytoma,6hyperaldosteronism cases,3hypercortisolism, and2mixed type cases were all bilateral adrenocortical adenoma. In nonfunctional tumor group,4cases were bilateral adrenal pheochromocytoma,2cases were bilateral adrenocortical adenoma. Mean operation time was50±7.15min. Mean blood loss was30±6.30ml. None surgery convert to open surgery. Mean hospital stay was14±1.50day.6months to3years follow-ups for each patient showed that patients’ blood pressure, biochemical indexes and hormone level were all normal or at least improved, no recurrence or adrenal dysfunctional symptoms showed.Conclusion:Imageology examinations are efficient and effective methods to diagnose bilateral primary adrenal masses. Minimally invasive surgery treatment is safe and effective for this disease. For a typical patient, we can perform laparoscopic unilateral adrenal tumor resection, and do the offside base on follow-up assessments. |
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