Comparison of Laparoscopic and Open Adrenalectomy

Abstract Laparoscopic adrenalectomy is one of the most significant advances in the past 20 years for treating adrenal disorders. Laparoscopic adrenalectomy has been the golden standard procedure for all adrenal pathologies since it was first defined in 1992. Laparoscopic adrenalectomy is preferred and has advantages such as less postoperative pain, earlier resumption of oral intake, shorter hospital stay, earlier return to normal life and better esthetical results. In our study we compared morbidity and mortality rates of laparoscopic and open adrenalectomy cases. Material and methods : In Ankara University Faculty of Medicine General Surgery department 92 cases of adrenalectomy were performed between january 2000-july 2006. The patients were evaluated for age, sex, duration of perioperative hospital stay, resumption of oral intake, duration of operation, surgical wound infection, conversion rate and complications. Results : In patients who underwent laparoscopic surgery, rate of conversion to open surgery was 9.3% (4 patients). The mean operative duration in the laparoscopic adrenalectomy group was 150 minutes and the mean operative duration in the open adrenalectomy group was 120 minutes (p = 0.001). Surgical wound infection rate was 6% in the open adrenalectomy group and 2% in the laparoscopic adrenalectomy group. Mean perioperative hospital stay was 7.1 days in the open adrenalectomy group and 5.1 days in the laparoscopic adrenalectomy group. Time to resumption of oral intake was 2.42 days in the open adrenalectomy group and 1.05 days in the laparoscopic adrenalectomy group (p = 0.001). There was no perioperative mortality in none of the groups. Conclusion : Laparoscopic adrenalectomy is the golden standard surgical treatment for benign and selected malignant adrenal diseases. Laparoscopic adrenalectomy is a safe and effective technique and has advantages such as less postoperative pain, earlier resumption to oral intake, shorter hospital stay, earlier return to normal life and better esthetical results compared to open adrenalectomy.

[1]  M. Raffaelli,et al.  Complications of Laparoscopic Adrenalectomy: Results of 169 Consecutive Procedures , 2000, World Journal of Surgery.

[2]  J. Klecka,et al.  [Laparoscopic adrenalectomy]. , 2009, Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti.

[3]  W. Ludlam,et al.  Improved Quality of Life After Bilateral Laparoscopic Adrenalectomy for Cushing's Disease: A 10-Year Experience , 2007, Annals of surgery.

[4]  H. Bonjer,et al.  Endoscopic retroperitoneal adrenalectomy , 1999, Acta Chirurgica Austriaca.

[5]  H. S. Bhat,et al.  Laparoscopic adrenalectomy is feasible for large adrenal masses>6 cm. , 2007, Asian journal of surgery.

[6]  P. Farling,et al.  Laparoscopic adrenalectomy versus open adrenalectomy: results from a retrospective comparative study , 2006, The Ulster medical journal.

[7]  P. Chowbey,et al.  Laparoscopic Approach to Pheochromocytoma: Is a Lower Intraabdominal Pressure Helpful? , 2006, Anesthesia and analgesia.

[8]  G. Kaltsas,et al.  Laparoscopic surgery for adrenal tumors. A retrospective analysis. , 2006, Hormones.

[9]  K. Kaczirek,et al.  Applicability of laparoscopic adrenalectomy in a prospective study in 150 consecutive patients. , 2004, Archives of surgery.

[10]  M. Addis,et al.  Minimally invasive endocrine surgery , 2003 .

[11]  H. Zeh,et al.  One Hundred Laparoscopic Adrenalectomies: A Single Surgeon’s Experience , 2003, Annals of surgical oncology.

[12]  C. Lo,et al.  Applicability and outcome of laparoscopic adrenalectomy. , 2003, Asian journal of surgery.

[13]  D. Oertli,et al.  Laparoscopic adrenalectomy: the new standard? , 2002, Swiss medical weekly.

[14]  E. Berber,et al.  Laparoscopic management of a posterior mediastinal tumor mimicking an adrenal neoplasm. , 2000 .

[15]  M. Talamini,et al.  Laparoscopic adrenalectomy for nonmalignant disease: improved safety, morbidity, and cost-effectiveness , 1999, Surgical Endoscopy.

[16]  J. Hiatt,et al.  Comparison of laparoscopic and open adrenalectomy. , 1997, The American surgeon.

[17]  N J Soper,et al.  Laparoscopic adrenalectomy compared to open adrenalectomy for benign adrenal neoplasms. , 1996, Journal of the American College of Surgeons.

[18]  R. Prinz.  A comparison of laparoscopic and open adrenalectomies. , 1995, Archives of surgery.

[19]  M. Takeda,et al.  Laparoscopic adrenalectomy for Cushing's syndrome: comparison with primary aldosteronism. , 1995, Surgery.

[20]  P. Bonnet,et al.  Laparoscopic adrenalectomy in pheochromocytoma and Cushing's syndrome. Reflections about two case reports. , 1994, Acta chirurgica Belgica.

[21]  M. Gagner,et al.  Laparoscopic adrenalectomy in Cushing's syndrome and pheochromocytoma. , 1992, The New England journal of medicine.