Young Jun Chai1, Hyeong Won Yu2, Ra-Yeong Song3, Su-Jin Kim4, June Young Choi2, Kyu Eun Lee4. 1. Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea. 2. Department of Surgery, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea. 3. Department of Surgery, Chung-Ang University Hospital, Seoul, Korea. 4. Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea.
Abstract
OBJECTIVE: The aim of this study was to compare the surgical outcomes of lateral transperitoneal adrenalectomy (LTA) and posterior retroperitoneoscopic adrenalectomy (PRA) for benign adrenal tumor. BACKGROUND: Although LTA is the standard treatment for benign adrenal gland tumor, PRA has recently gained popularity. Studies comparing the surgical outcomes of the 2 approaches have reported conflicting findings and thus it remains unclear which approach is superior. METHODS: This trial was conducted between September 2012 and February 2016. Patients were randomized to either LTA or PRA groups in a 1:1 ratio using web-based randomization. The primary outcome was operative time, and the secondary outcomes were blood loss, intraoperative hemodynamic stability, postoperative pain, recovery of bowel movement, and complication rates. This trial was registered with ClincalTrials.gov, number NCT01676025. RESULTS: A total of 83 patients were randomly assigned to the LTA group (n = 42) or the PRA group (n = 41). Median follow-up was 31.3 months. The mean operative times of LTA and PRA were comparable (59.7 ± 18.6 vs 67.6 ± 28.7 minutes, P = 0.139). Logistic regression analysis showed that male sex [odds ratio (OR) = 4.20] and pheochromocytoma (OR = 5.06) were associated with an operative time ≥60 minutes. There were no differences in the secondary outcomes between the groups. One patient in the PRA group required open conversion. CONCLUSION: Both LTA and PRA were performed safely with similar operative outcomes, and thus are comparable options for the treatment of benign adrenal gland tumor.
RCT Entities:
OBJECTIVE: The aim of this study was to compare the surgical outcomes of lateral transperitoneal adrenalectomy (LTA) and posterior retroperitoneoscopic adrenalectomy (PRA) for benign adrenal tumor. BACKGROUND: Although LTA is the standard treatment for benign adrenal gland tumor, PRA has recently gained popularity. Studies comparing the surgical outcomes of the 2 approaches have reported conflicting findings and thus it remains unclear which approach is superior. METHODS: This trial was conducted between September 2012 and February 2016. Patients were randomized to either LTA or PRA groups in a 1:1 ratio using web-based randomization. The primary outcome was operative time, and the secondary outcomes were blood loss, intraoperative hemodynamic stability, postoperative pain, recovery of bowel movement, and complication rates. This trial was registered with ClincalTrials.gov, number NCT01676025. RESULTS: A total of 83 patients were randomly assigned to the LTA group (n = 42) or the PRA group (n = 41). Median follow-up was 31.3 months. The mean operative times of LTA and PRA were comparable (59.7 ± 18.6 vs 67.6 ± 28.7 minutes, P = 0.139). Logistic regression analysis showed that male sex [odds ratio (OR) = 4.20] and pheochromocytoma (OR = 5.06) were associated with an operative time ≥60 minutes. There were no differences in the secondary outcomes between the groups. One patient in the PRA group required open conversion. CONCLUSION: Both LTA and PRA were performed safely with similar operative outcomes, and thus are comparable options for the treatment of benign adrenal gland tumor.
Authors: Alberto Arezzo; Alberto Bullano; Giovanni Cochetti; Roberto Cirocchi; Justus Randolph; Ettore Mearini; Andrea Evangelista; Giovannino Ciccone; H Jaap Bonjer; Mario Morino Journal: Cochrane Database Syst Rev Date: 2018-12-30
Authors: Ju Yong Oh; Ho Seok Chung; Seong Hyeon Yu; Myung Soo Kim; Ho Song Yu; Eu Chang Hwang; Kyung Jin Oh; Sun-Ouck Kim; Seung Il Jung; Taek Won Kang; Kwangsung Park; Dongdeuk Kwon Journal: Investig Clin Urol Date: 2020-02-05