OBJECTIVE: To compare the intraoperative and postoperative outcomes of laparoscopic versus open adrenalectomy for surgical adrenal disease. MATERIALS AND METHODS: Prospectively collected data from 22 consecutive laparoscopic adrenalectomies, performed by one surgeon (MGH) over a period of 18 months at the Royal Alexandra Hospital, Edmonton, Alberta, were reviewed. Laparoscopic adrenalectomy was performed by both the transperitoneal and retroperitoneal approaches. In addition, a retrospective chart review was performed for all open adrenalectomies, performed at the same institution, over a 6 year period. Exclusion criteria were locally invasive lesions and masses greater than 8 cm in diameter. Adrenal pheochromocytomas were included in both groups. The two groups were evaluated with respect to intraoperative and postoperative outcomes. RESULTS: Twenty-two laparoscopic and 19 open adrenalectomies were reviewed. Both groups were similar with regard to gender, age, body mass index, and ASA class. Two laparoscopic cases, both with a history of prior ipsilateral adrenal surgery, were converted to the open approach. The laparoscopic group had a longer mean operative time (171 minutes versus 104 minutes), yet had a lower estimated blood loss (146 cc versus 455 cc), blood transfusion rate (0% versus 16%), and intraoperative complication rate (5% versus 16%). Both groups were similar with regard to specimen size and pathology. The laparoscopic group required less post-operative analgesia (44 mg morphine versus 478 mg morphine), resumed a regular diet sooner (1.1 days versus 3.7 days), and had a shorter hospital stay (2.2 days versus 5.4 days). CONCLUSIONS: In our experience, prior ipsilateral adrenal surgery greatly increases the risk of open conversion. This study is consistent with the findings of a number of previously reported studies, supporting the emergence of laparoscopic adrenalectomy as the standard of care for surgical management of benign adrenal disease.
OBJECTIVE: To compare the intraoperative and postoperative outcomes of laparoscopic versus open adrenalectomy for surgical adrenal disease. MATERIALS AND METHODS: Prospectively collected data from 22 consecutive laparoscopic adrenalectomies, performed by one surgeon (MGH) over a period of 18 months at the Royal Alexandra Hospital, Edmonton, Alberta, were reviewed. Laparoscopic adrenalectomy was performed by both the transperitoneal and retroperitoneal approaches. In addition, a retrospective chart review was performed for all open adrenalectomies, performed at the same institution, over a 6 year period. Exclusion criteria were locally invasive lesions and masses greater than 8 cm in diameter. Adrenal pheochromocytomas were included in both groups. The two groups were evaluated with respect to intraoperative and postoperative outcomes. RESULTS: Twenty-two laparoscopic and 19 open adrenalectomies were reviewed. Both groups were similar with regard to gender, age, body mass index, and ASA class. Two laparoscopic cases, both with a history of prior ipsilateral adrenal surgery, were converted to the open approach. The laparoscopic group had a longer mean operative time (171 minutes versus 104 minutes), yet had a lower estimated blood loss (146 cc versus 455 cc), blood transfusion rate (0% versus 16%), and intraoperative complication rate (5% versus 16%). Both groups were similar with regard to specimen size and pathology. The laparoscopic group required less post-operative analgesia (44 mg morphine versus 478 mg morphine), resumed a regular diet sooner (1.1 days versus 3.7 days), and had a shorter hospital stay (2.2 days versus 5.4 days). CONCLUSIONS: In our experience, prior ipsilateral adrenal surgery greatly increases the risk of open conversion. This study is consistent with the findings of a number of previously reported studies, supporting the emergence of laparoscopic adrenalectomy as the standard of care for surgical management of benign adrenal disease.
Authors: Patrick Heger; Pascal Probst; Felix J Hüttner; Käthe Gooßen; Tanja Proctor; Beat P Müller-Stich; Oliver Strobel; Markus W Büchler; Markus K Diener Journal: World J Surg Date: 2017-11 Impact factor: 3.352
Authors: Brenessa Lindeman; Daniel A Hashimoto; Yanik J Bababekov; Sahael M Stapleton; David C Chang; Richard A Hodin; Roy Phitayakorn Journal: Surgery Date: 2017-11-08 Impact factor: 3.982
Authors: Kevin P Asher; Gopal N Gupta; Ronald S Boris; Peter A Pinto; W Marston Linehan; Gennady Bratslavsky Journal: Eur Urol Date: 2011-04-09 Impact factor: 20.096