Retroperitoneoscopic adrenalectomy: Conn's syndrome
Autores
Marta Antunes Marques, Alexandra Antunes, Luís Castro, Marta Silva, Fernando Manso, Joaquim Costa Pereira
Resumo Introdução
Recently, retroperitoneoscopie adrenalectomy has gained popularity among surgeons. However, there is an ongoing debate regarding whether the anterior or posterior approach is the best route to the adrenal gland. The retroperitoneoscopic approach provides excellent exposure when compared to the laparoscopic removal of the left adrenal gland, which requires retraction of surrounding organs such as the pancreatic tail, transverse and descending colon, and spleen.
Resumo Métodos
Clinical case and vídeo presentation.
Resumo Resultados
We report a case of a 37-year-old patient with no relevant medical history except for hypertension, who underwent an abdominal CT scan due to renal lithiasis. It revealed an incidentaloma on the left adrenal gland. A severe hypokalemia and a 4 cm solid nodule consistent with adrenocortical adenoma were detected, and the patient was referred to Endocrinology. After a more detailed laboratory investigation, the diagnosis was confirmed a primary hyperaldosteronism - Conn's syndrome. Spironolactone and potassium supplements were initiated, and surgery was proposed. After medical optimization, the patient underwent a retroperitoneal left adrenalectomy, which was uneventful, and he was discharged the following.
Resumo Discussão
In conclusion, retroperitoneoscopic adrenalectomy is a viable option for small adrenal tumors. Recent studies have demonstrated its superiority over other techniques in selected patients in terms of operation time, pain, blood loss, complication rate, and return to normal activity.