Retroperitoneal laparoscopic surgery versus open adrenalectomy: report of 149 cases / 中华内分泌外科杂志

ABSTRACT

Objective To evaluate and compare open and retroperitoneal laparoscopic adrenalectomy.Methods Clinical data of 30 cases undergoing open adrenalectomy and 119 cases undergoing retroperitoneal laparoscopic surgery were retrospectively analyzed. The 2 groups were compared in terms of these aspects operation duration, intraoperative blood loss, postoperative analgesic use, time to remove drainage tube, time to resume eat, postoperative hospitalization time, complications, and tumor recurrence. In open surgery group, tumor diameter was between 0.5 cm -10.8 cm, 4.57 cm in average. 18 tumors were located on the left side and 12 tumors on the right side. In laparoscopic group, tumor diameter was between 0.8 cm -14.5 cm, 2.78 cm in average. 59tumors were located on the left side and 60 tumors on the right side. Patients in open surgery group were followed up for 6-72 months and retroperitoneal laparoscopic group 4-20 months. Results Open adrenalectomy were successful in all the 30 cases. 12 cases in laparoscopic surgery group converted to open surgery among whom 8 cases were due to poor visibility, 1 case due to renal artery injury, 1 case due to large tumor size, 1 case because of diaphragmatic injury and 1 case because of pleural injury. Laparoscopic surgery was superior to open surgery in terms of operation duration, intraoperative blood loss, postoperative analgesic use, time to start food taking, time to remove drainage tube, and postoperative hospitalization time. The difference had statistical significance (P ＜0.05 ). Conclusion Retroperitoneal laparoscopic adrenalectomy has advantages such as less trauma, less blood loss, and shorter recovery time, which make this procedure the modern golden standard for treatment of benign adrenal neoplasm.