Manejo quirúrgico del incidentaloma suprarrenal

Abstract

Background: The adrenal incidentaloma is a lesion found on imaging studies for diagnosis of non-adrenal disorders. Most of these patients are not of surgical treatment. Our objective was to describe the clinical features and results of surgical management of adrenal incidentalomas in the Hospital de la Universidad de Chile. Material and Methods: Retrospective descriptive study. Period 2000 to 2009. Information was gathered from medical records and biopsies registers of patients with operated adrenal incidentaloma. Results: We evaluated 24 patients undergoing surgery, 66.7% female, 58.3% between 41 and 70 years. 58.3% were found in the study of abdominal pain. Surgical indications were: size ≥ 4 cm, enlarged in controls, atypical features in the abdominal and pelvic CT and/or functionality. 54.2% were ≥ 4 cm, 16.7% increase in size in controls, 45.8% had atypical features in the abdominal and pelvic CT and 33.3% were functioning, being the most frequent hypercortisolism. In 87.5% of patients the approach was laparoscopically. The morbidity was 12.6% (pneumonia, wound infection and stroke) and perioperative mortality was 0%. Discussion: The adrenal incidentaloma is a rare indication for surgery of adrenal tumors. Before the intervention should be studies in order to evaluate functionality and suspicion of malignancy. Functionating tumors and suspicious of malignancy should be resected, being the laparoscopic approach the election, likely in most cases. Key words: Adrenal tumors, adrenal incidentaloma, laparoscopic adrenalectomy.