Laparoscopic adrenalectomy: comparison with open adrenalectomy.

The results of the first 6 cases of laparoscopic adrenalectomy were compared with the most recent 11 consecutive cases of traditional open adrenalectomy for the treatment of benign adrenal tumor. In both groups, all the tumors were less than 4 cm in diameter and were removed successfully with no significant complications. The weight of the resected specimen and estimated blood loss were not significantly different in the two groups, and none of the patients needed a blood transfusion. Although laparoscopic adrenalectomy required a significantly longer operation time (median 230 min vs. 165 min for an open operation), the postoperative recovery estimated by the duration of restricted oral intake or walking was shorter, and the incidence of patients requiring postoperative parenteral analgesics was also significantly lower in laparoscopic adrenalectomy. Although the number of patients treated with the laparoscopic procedure is still small, these results suggest that laparoscopic adrenalectomy is a minimally invasive alternative to open adrenalectomy and, with further improvement of the operative technique and equipment, may become a more reliable and standard procedure for the treatment of benign adrenal tumor.