IngentaConnect ES06ADRENALECTOMY IN THE LAPAROSCOPIC ERA

Abstract:

Background

Laparoscopic adrenalectomy is now the accepted standard of care in surgical treatment of most forms of adrenal pathology. This study aims to review our experience with both the laparoscopic and open techniques over a 12 year period. Methods

A retrospective review of patients who underwent adrenalectomy by the same surgeon between January 1995 and December 2006 was performed. Laparoscopic and open adrenalectomy were compared in terms of operating time, length of stay and peri-operative morbidity. Patient demographics and tumour characteristics were also studied. Results

There were 82 adrenalectomies performed over the 12 year period. Sixty-one were completed laparoscopically, 17 were performed open and four were converted from a laparoscopic to an open procedure. The indications for surgery included 30 phaeochromocytomas, 20 non-functioning cortical adenomas, 9 aldosteronomas, 6 cortisol-producing adenomas, 3 adrenocortical carcinomas, 3 pseudocysts, 3 cortical hyperplasias, 2 cortical cysts, and one each of heamangioma, angiolipoma, myelolipoma, haematoma, lymphoma and adrenal metastasis. The average operating time for laparoscopic adrenalectomy was 114 minutes vs 159 minutes for open procedures. Laparosopic adrenalectomy was associated with significantly shorter length of stay (2.6 vs 7.4 days) and decreased post-operative morbidity (6.4% vs 42%). There was no peri-operative mortality. Conclusion

Our results concur with other retrospective reviews comparing laparoscopic and open adrenalectomy, demonstrating unequivocal advantages in terms of reduced operating time, length of stay and post-operative morbidity.

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