{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T10:13:58Z","timestamp":1768990438511,"version":"3.49.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2005,4,26]],"date-time":"2005-04-26T00:00:00Z","timestamp":1114473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,5,23]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Endoscopic adrenalectomy has become the treatment of choice for small benign adrenal tumours but should not be used for malignant lesions. It is debatable whether large and therefore potentially malignant primary adrenal tumours should be removed by minimally invasive techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three hundred and eighty primary adrenal tumours in 368 patients (142 male and 226 female; mean(s.d.) age 48\u00b79(14\u00b74) years) were excised by laparoscopic or retroperitoneoscopic adrenalectomy. Adrenal neoplasias exceeded 6 cm in diameter (range 6\u201313 cm) in 33 patients (18 male and 15 female; age 42\u00b76(14\u00b72) years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no deaths. Patients with large tumours had an increased conversion rate (P = 0\u00b7039), longer operating time (P &amp;lt; 0\u00b7001) and greater intraoperative blood loss (P = 0\u00b7007) than those with smaller lesions, but a similar overall morbidity rate (P = 0\u00b7207). Six malignant tumours were identified (diameter 4\u201310 cm; four phaeochromocytomas and two adrenocortical carcinomas). Local recurrence developed in two patients and distant metastasis occurred in all six patients with malignant lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endocopic adrenalectomy perfomed by an experienced surgeon should be the treatment of choice for tumours exceeding 6 cm in diameter.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.4964","type":"journal-article","created":{"date-parts":[[2005,4,26]],"date-time":"2005-04-26T17:48:07Z","timestamp":1114537687000},"page":"719-723","source":"Crossref","is-referenced-by-count":75,"title":["Endoscopic treatment of large primary adrenal tumours"],"prefix":"10.1093","volume":"92","author":[{"given":"M K","family":"Walz","sequence":"first","affiliation":[{"name":"Department of Surgery and Centre of Minimally Invasive Surgery, Kliniken Essen-Mitte, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Petersenn","sequence":"additional","affiliation":[{"name":"Department of Endorinology, University of Duisburg-Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J A","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kliniken Essen-Mitte, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Mann","sequence":"additional","affiliation":[{"name":"Department of Endorinology, University of Duisburg-Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H P H","family":"Neumann","sequence":"additional","affiliation":[{"name":"Medical Department IV, University of Freiburg, Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K W","family":"Schmid","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University of Duisburg-Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2005,4,26]]},"reference":[{"key":"2021070906133214400_bib1","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1007\/s00268-002-6666-0","article-title":"Results of laparoscopic adrenalectomy for large and potentially malignant tumors","volume":"26","author":"Henry","year":"2002","journal-title":"World J Surg"},{"key":"2021070906133214400_bib2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1089\/end.2000.14.149","article-title":"Laparoscopic adrenalectomy for large-volume (&gt; or = 5 cm) adrenal masses","volume":"14","author":"Hobart","year":"2000","journal-title":"J Endourol"},{"key":"2021070906133214400_bib3","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1093\/jjco\/hyd027","article-title":"The surgical approach to the adrenal gland: a comparison of the retroperitoneal and the transabdominal routes in 326 operations on 284 patients","volume":"30","author":"Nagesser","year":"2000","journal-title":"Jpn J Clin Oncol"},{"key":"2021070906133214400_bib4","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1007\/s002689900553","article-title":"Retroperitoneal adrenalectomy: open or endoscopic?","volume":"22","author":"Bonjer","year":"1998","journal-title":"World J Surg"},{"key":"2021070906133214400_bib5","first-page":"101","article-title":"Indications for adrenalectomy in the laparoscopic era","volume":"22","author":"Pisanu","year":"2001","journal-title":"G Chir"},{"key":"2021070906133214400_bib6","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/S0022-5347(01)62884-2","article-title":"Laparoscopic adrenalectomy: the preferred choice? 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