Comparison of Perioperative Outcomes in Patients Undergoing Robotic and Laparoscopic Adrenalectomy

Kook, Ha Rim; Lee, Jung Keun; Oh, Jong Jin; Lee, Sangchul; Hong, Sung Kyu; Byun, Seok Soo; Lee, Sang Eun

Abstract

PURPOSE
To compare outcomes of robotic adrenalectomy with conventional laparoscopic adrenalectomy.
MATERIALS AND METHODS
This retrospective study included 63 patients who underwent robotic or laparoscopic adrenalectomy between March 2005 and April 2016, with all operations performed using a transperitoneal approach. Outcomes were compared in the 29 patients who underwent robotic adrenalectomy and the 34 who underwent conventional laparoscopic adrenalectomy.
RESULTS
Mean age (53.1±12.2 years vs. 51.4±15.1 years, p=0.631) and body mass index (25.9±3.8 kg/m2 vs. 25.2±3.5 kg/m2, p=0.461) were similar in the robotic and laparoscopic groups. A significant percentage of patients in the robotic group had undergone prior abdominal surgery (38% vs. 12%, p=0.015). Mean tumor sizes (3.0±1.5 cm vs. 3.7±2.7 cm, p=0.134) and the percentage of incidentalomas (75.9% vs. 73.5%, p=0.354) were similar in the robotic and laparoscopic groups. There were no statistical significance between-group differences in tumor size, operative time, estimated blood loss, perioperative hemoglobin change, length of hospital stay, and complication rates. Pathologic diagnosis showed that pheochromocytoma (21% vs. 3%) and metastatic tumor (24% vs. 6%) were more frequent in the robotic than in the laparoscopic group (p=0.019). Subgroup analysis of patients with low tumor volume (â‰¤6.8 cm3) showed that operation time was significantly shorter in the robotic than in the laparoscopic group (p=0.045).
CONCLUSIONS
Robotic adrenalectomy is feasible, with outcomes comparable to those of laparoscopic adrenalectomy.