Clinical comparison of three approaches laparoscopic adrenalectomy

Abstract

Objective To explore the clinical value of three approaches laparoscopic adrenalectomy,including:the lateral position retroperitoneal approach (group A),the lateral position anterior abdominal approach (group B) and 70 ° recumbency position under costal arch transabdominal approach (group C).Methods The total of 219 patients who underwent laparoscopic adrenal surgery by the three approaches were involved.The three groups were compared with tumor size,operative time,blood loss,postoperative intestinal function recovery time,hospital stay,postoperative complications and operating comfort score indicators.Results Of the 219 cases,212 were successful and 7 required conversion to open surgery.There were no statistically significant differences among the three groups in terms of mean tumor size,mean operative time,postoperative intestinal function recovery time and the average hospital stay,however,average volumes of blood loss was 57.5 ml in group A,which more than that in group B 42.7 ml and group C 35.2 ml.The reference visual analogue scale mode operating comfort rating:A group is 6.3,B group is 5.9,C group is 7.4.Conclusion Three surgical approach can be effective in treating adrenal adenoma,A reasonable choice of surgical approach recommended based on proficiency,tumor size and patient body type. Key words: Adrenal surgery ; Laparoscopy ; Intraperitoneally ; Retroperitoneal