Transperitoneal Laparoscopic Adrenalectomy: A Single Surgeon Experience

Park, Min Young; Jeong, Byong Chang; Kim, Hyeon Hoe

Abstract

PURPOSE: We present a single surgeon experience of 52 cases of transperitoneal laparoscopic adrenalectomy for various adrenal diseases.
MATERIALS AND METHODS
Transperitoneal laparoscopic adrenalectomy (n= 52) for various adrenal diseases was performed by a single surgeon from February 1998 to December 2004. Clinical diagnosis of the subjects included 17 cases of primary aldosteronism, 11 of adrenal adenoma causing Cushing's syndrome, 3 of pheochromocytoma and 21 of nonfunctioning adenoma. The 52 patients were divided into 3 groups according to the time when operations were performed: early group of 18 patients, intermediate group of 17 patients, and late group of 17 patients. The mean operative time, mean estimated blood loss (EBL) and complication of each group were investigated to analyze the single surgeon's learning curve.
RESULTS
All laparoscopic adrenalectomies were successfully completed in all 52 patients. The mean operative time, mean EBL, mean tumor size, and mean postoperative hospital stay were 124 minutes (60-360), 56cc (30-300), 2.7cm (1-4.7), and 3.8 days (3-8), respectively. The mean time to solid diet and ambulation were 1.5 days and 1 day, respectively. There was no serious intraoperative or postoperative complication. Statistically, the mean operative time and estimated blood loss showed a significant reduction in the intermediate and late group compared with the early group.
CONCLUSIONS
Our results showed that transperitoneal laparoscopic adrenalectomy is a safe and effective surgical treatment modality in adrenal diseases.