Korean J Urol.
2005 Sep;46(9):931-937.
Clinical Experience of Laparoscopic Transperitoneal Adrenalectomy
- Affiliations
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- 1Department of Urology, College of Medicine, Pusan National University Hospital, Busan, Korea. toohotman@hanmail.net
- 2Department of Endocrinology, College of Medicine, Pusan National University Hospital, Busan, Korea.
- 3Department of Urology, Baptist Hospital, Busan, Korea.
Abstract
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PURPOSE: A laparoscopic procedure is considered the treatment of choice for an adrenalectomy. We report our experience of a laparoscopic transperitoneal adrenalectomy in a series of 41 patients.
MATERIALS AND METHODS
Between February 1999 and September 2004, 41 consecutive patients underwent a laparoscopic transperitoneal adrenalectomy. The indications for a adrenalectomy were primary aldosteronism in 16 patients, Cushing's syndrome in 7, pheochromocytoma in 6, nonfunctional adenoma in 5, adrenal cyst in 3, benign cystic teratoma in 2, myelolipoma in 1 and metastatic renal cell carcinoma in 1. The author analyzed the results of each operation.
RESULTS
The affected adrenal gland was successfully removed, with the exception of 3 cases. Conversion to open surgery was necessary in 3 of the pheochromocytoma patients due to massive intraoperative bleeding and severe adhesion to retroperitoneal fat. The mean operative time was 245.3 minutes (125-420). The mean intraoperative blood loss and adrenal mass size were 189.6ml (20-2100) and 3.6cm (1.0-10.4), respectively. The mean post-operative hospital stay was 10.4 days (5-29). The mean times to oral intake and ambulation were 1.4 (1-3) and 1.0 days (1-2) after the operation, respectively. The mean number of days of analgesic administration was 2.1 (0-6). The conversion and major complication rates were 7.3 and 10.5%, respectively.
CONCLUSIONS
A laparoscopic adrenalectomy is safe and effective in nearly all adrenal pathologies, with early oral intake, ambulation and a low number of days of pain control.
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