Our Summary

This research paper discusses a study conducted on 25 children who had adrenal tumors and underwent a surgery known as laparoscopic adrenalectomy (LA). This surgery is a common practice in adults and involves removing the adrenal gland. It is less common in children, but the study aimed to share its experiences in using it on children.

The study found that the surgery was performed on a mix of malignant (cancerous) and benign (non-cancerous) tumors. The tumors ranged in size and were more common on the right side, with one case involving both sides. The surgery was successful in all cases, with no need to switch to open surgery and no complications reported over a 3-year follow-up period.

In addition to their own experiences, the researchers also reviewed other studies and found that over 400 children had undergone this surgery, mostly on the left side and primarily for malignant tumors. In these other cases, the surgery was also mostly successful, although there were a few instances where surgeons had to switch to an open surgery and a few complications were reported.

In conclusion, the researchers believe that laparoscopic adrenalectomy is a good option for children with adrenal tumors, as long as the surgery is properly planned and performed by experienced surgeons.

FAQs

  1. What is laparoscopic adrenalectomy and is it suitable for children?
  2. What is the preferred surgical approach for pediatric laparoscopic adrenalectomy?
  3. What are the rates of conversion and complication in pediatric laparoscopic adrenalectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about adrenalectomy is to ensure they have a thorough preoperative evaluation and discussion with their surgeon. It is important to understand the potential risks and benefits of the procedure, as well as any specific instructions for preoperative preparation. Additionally, following postoperative care instructions and attending follow-up appointments are crucial for a successful recovery.

Suitable For

Patients who are typically recommended adrenalectomy include children with adrenal tumors, both malignant and benign, that are causing symptoms or are at risk of complications. Adrenalectomy may also be recommended for patients with adrenal hyperplasia or other adrenal gland disorders that are not responding to medical treatment. It is important for patients to be evaluated by a pediatric surgeon to determine if adrenalectomy is the best treatment option for their specific condition.

Timeline

  • Before adrenalectomy:
  1. Patient presents with symptoms such as abdominal pain, weight gain, high blood pressure, and hormonal imbalances.
  2. Imaging studies are conducted to diagnose the adrenal tumor and determine its size and location.
  3. Patient undergoes preoperative evaluation and preparation, including blood tests, imaging studies, and consultation with an endocrinologist.
  4. Surgical team discusses the risks and benefits of adrenalectomy with the patient and obtains informed consent.
  5. Patient is admitted to the hospital on the day of surgery and undergoes laparoscopic adrenalectomy.
  • After adrenalectomy:
  1. Patient is monitored in the recovery room for a few hours post-surgery.
  2. Pain management and monitoring of vital signs are provided in the hospital setting.
  3. Patient is discharged home with instructions for wound care, pain management, and follow-up appointments.
  4. Patient may experience temporary hormonal imbalances and require hormone replacement therapy.
  5. Follow-up appointments are scheduled to monitor the patient’s recovery and hormonal levels.
  6. Patient gradually resumes normal activities and lifestyle with guidance from the surgical team and endocrinologist.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with adrenalectomy in children?
  2. How will the surgery impact the child’s hormone levels and overall health?
  3. What is the expected recovery time and post-operative care for a child undergoing adrenalectomy?
  4. Will the child need any long-term follow-up or monitoring after the surgery?
  5. How experienced is the surgical team in performing adrenalectomies in children?
  6. Are there any specific dietary or lifestyle changes that the child will need to make after the surgery?
  7. What are the chances of the adrenal tumor being malignant, and how will this be determined?
  8. What alternative treatment options are available for the child’s adrenal condition?
  9. How will the child’s adrenal function be affected by the removal of one adrenal gland?
  10. Are there any specific considerations or precautions that need to be taken for a child undergoing adrenalectomy, compared to an adult?

Reference

Authors: Dokumcu Z, Divarci E, Ertan Y, Celik A. Journal: J Pediatr Surg. 2018 Sep;53(9):1800-1805. doi: 10.1016/j.jpedsurg.2017.11.055. Epub 2017 Nov 28. PMID: 29254846