{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T04:03:12Z","timestamp":1749873792120,"version":"3.41.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Retroperitoneoscopic adrenalectomy (RPA) has proven to be safe and feasible with favorable postoperative courses. The role of RPA for tumor sizes larger than 6\u00a0cm is still controversial. The aim of the study was to evaluate the postoperative outcome for removal of larger adrenal tumors via the retroperitoneoscopic route.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In this retrospective study, from 105 conducted RPA procedures, thirteen patients with adrenal tumor sizes larger than 6\u00a0cm received RPA in our hospital between January 2017 and December 2020. Clinicopathological factors, length of hospital stay, operative time and postoperative outcomes were included in this analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>From this patient cohort, six (46.15%) were female and seven (53.85%) were male with a mean age of 53.85\u2009\u00b1\u20097.89 years and a mean BMI of 28.64\u2009\u00b1\u20093.61\u00a0kg\/m2, Cushing\u2019s syndrome being the most common diagnosis (53.85%). Mean lesion size was 73.31\u2009\u00b1\u200910.39\u00a0mm, tumor size varied from 60\u00a0mm up to 92\u00a0mm.\u00a0Two patients (15.38%) required conversion to open laparotomy due to uncontrollable bleeding or an unclear view on the basis of adhesions. Postoperative complications were noted for one patient (7.69%), who suffered from a small superficial wound infection. Neither capsule ruptures nor mortality were documented. The median hospital stay was 3 days.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>A re-evaluation of the arbitrarily placed cut-off should be discussed, since even with a slightly higher but nevertheless acceptable risk of conversion rate, RPA offers many advantages.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00423-025-03769-7","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T04:19:14Z","timestamp":1749788354000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does size still matter? - Feasibility of posterior retroperitoneoscopic adrenalectomy for tumors &gt;6cm"],"prefix":"10.1007","volume":"410","author":[{"given":"Joy","family":"Feka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Soliman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melisa","family":"Arikan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Sacher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Binter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"Hargitai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Scheuba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Riss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"issue":"9","key":"3769_CR1","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1007\/s00104-022-01682-z","volume":"93","author":"MK Walz","year":"2022","unstructured":"Walz MK (2022) [Minimally invasive techniques in adrenal gland surgery]. Chirurgie (Heidelb) 93(9):850\u2013855","journal-title":"Chirurgie (Heidelb)"},{"issue":"3","key":"3769_CR2","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.eururo.2006.01.014","volume":"49","author":"M Zacharias","year":"2006","unstructured":"Zacharias M, Haese A, Jurczok A, Stolzenburg JU, Fornara P (2006) Transperitoneal laparoscopic adrenalectomy: outline of the preoperative management, surgical approach, and outcome. Eur Urol 49(3):448\u2013459","journal-title":"Eur Urol"},{"issue":"14","key":"3769_CR3","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1056\/NEJM199210013271417","volume":"327","author":"M Gagner","year":"1992","unstructured":"Gagner M, Lacroix A, Bolte E (1992) Laparoscopic adrenalectomy in cushing\u2019s syndrome and pheochromocytoma. N Engl J Med 327(14):1033","journal-title":"N Engl J Med"},{"issue":"7","key":"3769_CR4","first-page":"1130","volume":"83","author":"E Higashihara","year":"1992","unstructured":"Higashihara E, Tanaka Y, Horie S, Aruga S, Nutahara K, Homma Y et al (1992) [A case report of laparoscopic adrenalectomy]. Nihon Hinyokika Gakkai Zasshi 83(7):1130\u20131133","journal-title":"Nihon Hinyokika Gakkai Zasshi"},{"issue":"1","key":"3769_CR5","first-page":"1","volume":"183","author":"LM Brunt","year":"1996","unstructured":"Brunt LM, Doherty GM, Norton JA, Soper NJ, Quasebarth MA, Moley JF (1996) Laparoscopic adrenalectomy compared to open adrenalectomy for benign adrenal neoplasms. J Am Coll Surg 183(1):1\u201310","journal-title":"J Am Coll Surg"},{"issue":"8","key":"3769_CR6","doi-asserted-by":"publisher","first-page":"2629","DOI":"10.1245\/s10434-012-2352-0","volume":"19","author":"CR Lee","year":"2012","unstructured":"Lee CR, Walz MK, Park S, Park JH, Jeong JS, Lee SH et al (2012) A comparative study of the transperitoneal and posterior retroperitoneal approaches for laparoscopic adrenalectomy for adrenal tumors. Ann Surg Oncol 19(8):2629\u20132634","journal-title":"Ann Surg Oncol"},{"issue":"10","key":"3769_CR7","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1002\/bjs.4738","volume":"91","author":"A Assalia","year":"2004","unstructured":"Assalia A, Gagner M (2004) Laparoscopic adrenalectomy. Br J Surg 91(10):1259\u20131274","journal-title":"Br J Surg"},{"issue":"4","key":"3769_CR8","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1007\/s00423-019-01768-z","volume":"404","author":"K Lorenz","year":"2019","unstructured":"Lorenz K, Langer P, Niederle B, Alesina P, Holzer K, Nies C et al (2019) Surgical therapy of adrenal tumors: guidelines from the German association of endocrine surgeons (CAEK). Langenbecks Arch Surg 404(4):385\u2013401","journal-title":"Langenbecks Arch Surg"},{"issue":"Suppl 1","key":"3769_CR9","doi-asserted-by":"publisher","first-page":"S118","DOI":"10.1016\/j.ijsu.2015.12.042","volume":"28","author":"G Conzo","year":"2016","unstructured":"Conzo G, Tartaglia E, Gambardella C, Esposito D, Sciascia V, Mauriello C et al (2016) Minimally invasive approach for adrenal lesions: systematic review of laparoscopic versus retroperitoneoscopic adrenalectomy and assessment of risk factors for complications. Int J Surg 28(Suppl 1):S118\u2013S123","journal-title":"Int J Surg"},{"issue":"1","key":"3769_CR10","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1097\/MOU.0000000000000339","volume":"27","author":"MC Hupe","year":"2017","unstructured":"Hupe MC, Imkamp F, Merseburger AS (2017) Minimally invasive approaches to adrenal tumors: an up-to-date summary including patient position and Port placement of laparoscopic, retroperitoneoscopic, robot-assisted, and single-site adrenalectomy. Curr Opin Urol 27(1):56\u201361","journal-title":"Curr Opin Urol"},{"issue":"2","key":"3769_CR11","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1093\/bja\/aew392","volume":"118","author":"H Groeben","year":"2017","unstructured":"Groeben H, Nottebaum BJ, Alesina PF, Traut A, Neumann HP, Walz MK (2017) Perioperative alpha-receptor Blockade in Phaeochromocytoma surgery: an observational case series. Br J Anaesth 118(2):182\u2013189","journal-title":"Br J Anaesth"},{"issue":"6","key":"3769_CR12","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1210\/endrev\/bnaa008","volume":"41","author":"M Sherlock","year":"2020","unstructured":"Sherlock M, Scarsbrook A, Abbas A, Fraser S, Limumpornpetch P, Dineen R et al (2020) Adrenal Incidentaloma. Endocr Rev 41(6):775\u2013820","journal-title":"Endocr Rev"},{"issue":"4","key":"3769_CR13","first-page":"300","volume":"3","author":"LM Brunt","year":"1993","unstructured":"Brunt LM, Molmenti EP, Kerbl K, Soper NJ, Stone AM, Clayman RV (1993) Retroperitoneal endoscopic adrenalectomy: an experimental study. Surg Laparosc Endosc 3(4):300\u2013306","journal-title":"Surg Laparosc Endosc"},{"issue":"1","key":"3769_CR14","first-page":"53","volume":"120","author":"MK Walz","year":"1995","unstructured":"Walz MK, Peitgen K, Krause U, Eigler FW (1995) [Dorsal retroperitoneoscopic adrenalectomy\u2013a new surgical technique]. Zentralbl Chir 120(1):53\u201358","journal-title":"Zentralbl Chir"},{"issue":"6","key":"3769_CR15","first-page":"650","volume":"68","author":"MK Walz","year":"1997","unstructured":"Walz MK, Giebler RM (1997) [Endoscopic, retroperitoneal adrenalectomy]. Chirurg 68(6):650","journal-title":"Chirurg"},{"issue":"6","key":"3769_CR16","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1007\/s00104-011-2194-5","volume":"83","author":"MK Walz","year":"2012","unstructured":"Walz MK (2012) [Minimally invasive adrenal gland surgery. Transperitoneal or retroperitoneal approach?]. Chirurg 83(6):536\u2013545","journal-title":"Chirurg"},{"key":"3769_CR17","doi-asserted-by":"publisher","unstructured":"Mihai R, De Crea C, Guerin C, Torresan F, Agcaoglu O, Simescu R, Walz MK (2024) Surgery for advanced adrenal malignant disease: recommendations based on European Society of Endocrine Surgeons consensus meeting. Br J Surg 111(1):znad266. https:\/\/doi.org\/10.1093\/bjs\/znad266","DOI":"10.1093\/bjs\/znad266"},{"issue":"Suppl 1","key":"3769_CR18","doi-asserted-by":"publisher","first-page":"S36","DOI":"10.21037\/gs.2019.03.11","volume":"8","author":"PF Alesina","year":"2019","unstructured":"Alesina PF (2019) Retroperitoneal adrenalectomy-learning curve, practical tips and tricks, what limits its wider uptake. Gland Surg 8(Suppl 1):S36\u2013S40","journal-title":"Gland Surg"},{"key":"3769_CR19","doi-asserted-by":"publisher","first-page":"855326","DOI":"10.3389\/fendo.2022.855326","volume":"13","author":"PF Alesina","year":"2022","unstructured":"Alesina PF, Knyazeva P, Hinrichs J, Walz MK (2022) Tailored approach in adrenal surgery: retroperitoneoscopic partial adrenalectomy. Front Endocrinol (Lausanne) 13:855326","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"Suppl 2","key":"3769_CR20","doi-asserted-by":"publisher","first-page":"S5","DOI":"10.1186\/1471-2482-13-S2-S5","volume":"13","author":"G Conzo","year":"2013","unstructured":"Conzo G, Pasquali D, Della Pietra C, Napolitano S, Esposito D, Iorio S et al (2013) Laparoscopic adrenal surgery: ten-year experience in a single institution. BMC Surg 13(Suppl 2):S5","journal-title":"BMC Surg"},{"issue":"2","key":"3769_CR21","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1016\/j.soc.2018.11.011","volume":"28","author":"CM Kiernan","year":"2019","unstructured":"Kiernan CM, Lee JE (2019) Minimally invasive surgery for primary and metastatic adrenal malignancy. Surg Oncol Clin N Am 28(2):309\u2013326","journal-title":"Surg Oncol Clin N Am"},{"key":"3769_CR22","unstructured":"S2k-Leitlinie.\u00a0Operative therapie von Nebennierentumoren. AWMF-Registernummer 088\u2013\u2009008. https:\/\/register.awmf.org\/assets\/guidelines\/088-008l_S2k_Operative-Therapie_Nebennierentumoren_2019-07-abgelaufen.pdf"},{"issue":"4","key":"3769_CR23","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1016\/j.suc.2019.04.013","volume":"99","author":"A Madani","year":"2019","unstructured":"Madani A, Lee JA (2019) Surgical approaches to the adrenal gland. Surg Clin North Am 99(4):773\u2013791","journal-title":"Surg Clin North Am"},{"key":"3769_CR24","doi-asserted-by":"publisher","first-page":"667985","DOI":"10.3389\/fonc.2021.667985","volume":"11","author":"C Meng","year":"2021","unstructured":"Meng C, Du C, Peng L, Li J, Li J, Li Y et al (2021) Comparison of posterior retroperitoneoscopic adrenalectomy versus lateral transperitoneal laparoscopic adrenalectomy for adrenal tumors: A systematic review and Meta-Analysis. Front Oncol 11:667985","journal-title":"Front Oncol"},{"issue":"10","key":"3769_CR25","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1001\/jamasurg.2022.3544","volume":"157","author":"L Yip","year":"2022","unstructured":"Yip L, Duh QY, Wachtel H, Jimenez C, Sturgeon C, Lee C et al (2022) American association of endocrine surgeons guidelines for adrenalectomy: executive summary. JAMA Surg 157(10):870\u2013877","journal-title":"JAMA Surg"},{"issue":"11","key":"3769_CR26","doi-asserted-by":"publisher","first-page":"1977","DOI":"10.21037\/gs-24-286","volume":"13","author":"J Feka","year":"2024","unstructured":"Feka J, Soliman B, Arikan M, Binter T, Hargitai L, Scheuba C et al (2024) Benefits of transitioning from transperitoneal laparoscopic to retroperitoneoscopic adrenalectomy-a single center experience. Gland Surg 13(11):1977\u20131985","journal-title":"Gland Surg"}],"container-title":["Langenbeck's Archives of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-025-03769-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00423-025-03769-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-025-03769-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T04:19:16Z","timestamp":1749788356000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00423-025-03769-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,13]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3769"],"URL":"https:\/\/doi.org\/10.1007\/s00423-025-03769-7","relation":{},"ISSN":["1435-2451"],"issn-type":[{"value":"1435-2451","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,13]]},"assertion":[{"value":"30 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Joy Feka, Barbara Soliman, Melisa Arikan, Magdalena Sacher, Theresa Binter, Lindsay Hargitai, Christian Scheuba and Philipp Riss have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"189"}}