Đặc điểm lâm sàng, cận lâm sàng và kết quả phẫu thuật nội soi qua phúc mạc cắt u vỏ thượng thận tại Bệnh viện Nội tiết Trung ương

Adrenal tumors, particularly those affecting the adrenal cortex, present significant clinical challenges due to their hormonal activity and potential for various pathological syndromes where medical treatment alone is often insufficient. With the increasing prevalence detected incidentally during routine health check-ups and diagnostic imaging, coupled with a rising incidence with age, effective surgical management has become paramount. Laparoscopic surgery has emerged as a preferred method, offering benefits such as minimal invasiveness, reduced postoperative pain, and shorter recovery times, thereby improving patient outcomes. This study from the National Hospital of Endocrinology aims to critically assess the clinical characteristics of patients with adrenal cortical tumors and evaluate the efficacy and safety of transperitoneal laparoscopic surgery.

Medical professionals, surgeons, endocrinologists, researchers in endocrine surgery, and healthcare policymakers interested in the management of adrenal tumors.

This cross-sectional descriptive study investigated the clinical and paraclinical characteristics of 48 patients with adrenal cortical tumors who underwent conventional transperitoneal laparoscopic surgery at the National Hospital of Endocrinology between 2022 and 2025. The study aimed to describe patient profiles and evaluate surgical outcomes using a structured questionnaire. The findings revealed an average patient age of 47.6 years, with a female-to-male ratio of 2.43:1, and a notable 79.2% of tumors exhibiting endocrine activity. Paraclinical assessments, primarily via CT or MRI, indicated a distribution of 54.2% right-sided, 45.8% left-sided, and 2.1% bilateral tumors, with an average size of 2.4 ± 0.97 cm. The mean surgical time was 86.7 minutes. Complications included bleeding at the incision site in 8.3% of cases, and 79.2% of patients required abdominal drains, a rate positively correlated with larger tumor size (p=0.007). Deep surgical wound infections occurred in 4.2% of patients, and 12.5% experienced severe postoperative pain. Patients achieved defecation on average by 1.7 days post-surgery, with an average hospital stay of 6.45 days. The study concludes that regular health check-ups are crucial for early detection of adrenal tumors, particularly in the 40-59 age group and among women. Transperitoneal laparoscopic surgery for adrenal tumors is affirmed as a safe, highly effective, and minimally invasive treatment modality. These results reinforce the value of this surgical approach in managing adrenal cortical tumors and highlight areas for further optimization in postoperative care.