Clinical comparison of two approaches to laparoscopic adrenalectomy: transperitoneal versus retroperitoneal approach

Abstract

Objective To compare the clinical effect of two approaches to laparoscopic adrenalectomy: laparoscopic transperitoneal approach (LTA) and laparoscopic retroperitoneal adrenalectomy (LRA). Methods The clinical data of 89 cases underwent laparoscopic adrenalectomy from January 2012 to December 2016 in our department were retrospectively analyzed. The mean operative time, perioperative blood loss, tumor size, first oral intake and postoperative hospital stay were compared and analyzed between LTA and LRA groups Results LTA was performed in 42 patients and LRA in 47 patients. There was no significant difference in gender, age, history of abdominal surgery, antihypertensive medication history, preoperative blood pressure, preoperative heart rate, tumor location, clinical diagnosis and tumor size between LTA and LRA group (P>0.05). The mean operating time in LRA group was shorter than that in LTA [(78±17) min vs (90±21) min, P=0.0047)], especially for patients in the LRA group underwent right adrenalectomy [(80±14) min vs (93±10) min, P<0.001)]. However, those underwent left adrenalectomy had no significant difference between LRA group and LTA group [(84±14) min vs (87±11) min, P=0.144]. There was no significant difference in blood loss[(38±25) ml vs (44±32) ml, P=0.343] and tumor size. While there were significant differences in the average hospitalization and first oral intake between LRA and LTA (P<0.05). Conclusion LTA and LRA can be safe and effective. The mean operating time in PRA group was shorter than in LTA group, and the postoperative recovery in PRA was faster than that of the LTA group. Key words: Laparoscopic; Adrenalectomy; Approach