Efficacy of retroperitoneal laparoscopic and open adrenalectomy for huge adrenal tumors

Abstract

Objective To compare the similarities and differences of retroperitoneal laparoscopic and open surgeries for huge adrenal tumors (diameter≥6 cm) and to explore the clinical curative effect. Methods The retrospective analysis was made on the clinical data of 63 patients with huge adrenal tumor who underwent retroperitoneal laparoscopic adrenalectomy (n=23) and open surgery(n=40) from January 2009 to December 2015. The operative time, blood loss, blood transfusion volume, tumor size and postoperative hospital stay were comparatively analyzed. Results The operations were performed successfully in all 63 patients without converting to open surgery in retroperitoneal laparoscopic adrenalectomy. The tumor location, the gender and the age of patients of two groups were not significantly different (P>0.05). The tumor size, operative time, intraoperative blood loss and postoperative hospital stay were significantly different between the two groups(P<0.05). The results of pathological examination were as follows: pheochromocytoma in 22 cases (34.92%), adrenocortical adenoma in 9 cases (14.29%), myelolipoma in 7 cases (11.11%), adrenal cyst in 6 cases (9.52%), malignant tumors in 9 cases (14.29%), other pathologic types in 10 cases (15.87%). Conclusion For the experienced and skilled surgeons, whether adrenal tumors' diameter is 6 cm is no longer the absolute constrain to determine the operation methods. Retroperitoneal laparoscopic adrenalectomy is safe and effective. Little trauma and rapid postoperative recovery make it being worth popularizing clinically. Key words: Adrenal tumors; Adrenalectomy; Laparoscopy; Open surgery