Laparoscopic Adrenalectomy: A Comparison of Lateral Transperitoneal vs Posterior Retroperitoneal Approach

Ji-Young Sul, MD, PhD, Jeong-whan Cha, MD, Jun-Beom Park, MD. Chungnam National University Hospital

INTRODUCTION – Laparoscopic adrenalectomy has become the standard of care for a variety of benign adrenal pathology. One hundred and eleven consecutive adrenalectomies were performed using the lateral transperitoneal or posterior retroperitoneal approaches, each with their own inherent benefits and shortcomings. The authors compared the effectiveness and safety of posterior retroperitoneal adrenalectomy (PRA) with that of lateral transperitoneal adrenalectomy (LTA).

METHODS AND PROCEDURES – Medical records of 111 patients who were diagnosed with adrenal tumor and received laparoscopic adrenalectomy from January 2000 through April 2012 at Hospital were reviewed in retrospect. Study variables included operative time, length of hospital stay, days of pain control, diet beginning and advance, and complications

RESULTS – PRA was shorter in most variables including operative time, hospital stay, first diet beginning and full diet advance time compared with that of LTA. In pheochromocytoma less than or equal to 7 cm in size, LTA took longer time in operation than PRA. One of PRA-specific complications was pseudo-hernia of ipsilateral abdominal wall, which was resolved spontaneously in 1-2 months.

CONCLUSION – Laparoscopic adrenalectomy is a safe and effective approach to benign adrenal pathology, and PRA should be considered in patients with tumors less than or equal to 7 cm.

Keywords: Laparoscopic adrenalectomy, lateral transperitoneal approach, posterior retroperitoneal approach

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