AB066. The successful experiences of totally laparoscopic tumorectomy for a large adrenal neoplasm with two failed operations in other hospital—confidence, determination and courage

OBJECTIVE: We summarized the successful experiences of totally laparoscopic tumorectomy for a large adrenal neoplasm with two failed operations. METHODS: The retroperitoneal laparoscopic tumorectomy was performed on the patient with a large adrenal tumor by Professor Bao Zhang. The largest diameter of tumor was 10.5 cm. Two weeks ago, the neoplasm in the patient’s right adrenal gland was found by medical examination. Then two operations, included an open surgery and a laparoscopic operation, were performed in other hospital. Unfortunately, the tumor was not completely removed. In order to get a better treatment, the patient was transferred to our hospital. RESULTS: The retroperitoneal laparoscopic tumorectomy was a success without conversion to open surgery. The operation time was 90 min, and the blood loss was 100 mL. Pathological diagnosis is primary adrenocortical carcinoma. The drainage tube was removed at the third day after surgery and the postoperative hospital stay was 8 days. During the 6 months follow-up, no recurrence or metastasis was found. CONCLUSIONS: Totally laparoscopic tumorectomy is feasible and safe for patients with large adrenal tumors, and even for patients with failed treatment experiences. The diameter of the tumor does not determine the surgery feasibility. The successful experiences of complex operations are composed of confidence, determination and courage of the surgeon.