Abstract
Objective:The aim of this study was to compare the outcome of open adrenalectomy (OA) to laparoscopic adrenalectomy (LA) performed for benign adrenal tumors. Patints and methodes: The study was a prospective, randomized comparative study that included 32 patients with unilateral adrenal tumors who underwent adrenalectomy either open or laparoscopic in Ain Shams University Hospitals and Helwan University hospital between May 2015 and May 2017. Patients were divided into 2 groups: 16 patients underwent laparoscopic adrenalectomy (Group A) and 16 patients underwent open adrenalectomy (Group B). Patients with suspected malignancy were excluded from our study. Parameters including demographics, perioperative evaluation of patients, and postoperative pathological data were analyzed. Results: The study included 32 patients who underwent adrenalectomy either laparoscopically or by open surgery, it was done for pheochromocytoma (16 patients) and cortical adenomas (16 patients) (nine cases Cushing’s syndrome and seven Conn’s syndrome). There was one conversion to open technique in the laparoscopic group and no mortalities recorded in both groups. By comparing the 2 groups it was found that the mean operative time was longer in the laparoscopic group 162.63 min versus 146.50 in open group (p=0.019); with less intraoperative bleeding 86 ml vs 400 ml in open group (p < 0.001), but shorter postoperative recovery. Earlier toleration of diet (1.6 vs 3.5 days), shorter hospital stays (2.69 vs 5.44 days) and earlier return to normal activity (7.5 vs 13 days), (p < 0.001 for all) and less analgesic use (10 vs 30mg) (p < 0.001) in the laparoscopic group. Conclusion: Laparoscopic adrenalectomy for adrenal tumors is an effective and safe technique that is associated with significantly earlier toleration of diet, shorter hospital stays and earlier return to normal activity with less post-operative pain and complications, in spite of the fact that it could be a longer procedure.
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