Clinical Analysis of 155 Adrenal Cyst Cases
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Objective： To discuss the diagnosis and treatment for adrenal cysts, and evaluate the safety and efficacy of laparoscopic surgery for adrenal cysts.
Methods：During the period of 1990-1~2011-7, 155 patients with adrenal cysts underwent surgery in Peking Union Medical College Hospital. The preoperative symptoms, preoperative diagnosis, treatments, intra- and postoperative complications, subclassification of adrenal cysts by Histology, and follow-up in patients after surgery were reviewed respectively．
Results： We identified 155 patients who underwent surgery for adrenal cysts, and 62 cases were male, 93 female. The median age is 43 years.154 adrenal cysts were unilateral, and 1case is bilateral. The diameter is 2.6cm on average, ranging from 2 to 11cm.The accuracy of diagnosis of CT, MRI, and B-us is 92.2%, 86.4%, 61.0% respectively. By endocrinology test, 2 cases were diagnosed as primary aldosteronism, 2 cases as pheochromocytoma.146 laparoscopic operations were performed, and 9 open operations were performed. The time of operation for laparoscopy and open procedure is 55min and 153 min on average respectively, while the hospital stays after operation is 2.2days and 8.6 days respectively. No severe perioperative complications occurred. Subclassification of adrenal cysts by histology includes endothelial cysts(86/156), pseudocysts(67/156), and epithelial cysts(3/156). At follow-up, no patient suffered recurrence.
Conclusion: Diagnosis of adrenal cysts predominantly depends on imaging, especially enhanced CT. Preoperative endocrinology test is necessary. Surgery is recommended for large cysts greater than 5 cm, cystic endocrine active adrenal tumors and cysts with chances of malignancy by imaging. Laparoscopic surgery should be preferred as the first option for the surgical treatment of adrenal cysts. Keywords：adrenal cysts, diagnosis, treatment ,surgery，laparoscopy