A Clinical Review of 11 Cases of a Laparoscopic Adrenalectomy: Comparison with an Open Adrenalectomy

Choi, Jae Young; Koh, Suck Hwan; Lee, Kil Yeon; Lee, Suk Hwan; Lee, Sang Mok; Park, Ho Chul; Hong, Sung Wha; Oh, Soo Myung; Yoon, Choong

Abstract

PURPOSE
The laparoscopic adrenalectomy has become the golden standard procedure for adrenal tumors because of its many advantages. The purpose of our study was to compare the outcomes for patients who underwent a transperitoneal laparoscopic adrenalectomy with those of patients who had a conventional open adrenalectomy. Similar to the open adrenalectomy, the laparoscopic adrenalectomy was divided into anterior (LA: Laparoscopic anterior) and posterior (LP: Laparoscopic posterior) approaches.
METHODS
Between January 1991 and September 1998, a retrospective review of consecutive adrenalectomies performed at Kyung Hee University Hospital was done. Outcome measurements of operative indications, tumor size, operation time, first oral intake, postoperative stay, and postoperative complications were reviewed.
RESULTS
Eleven(11) laparoscopic adrenalectomies (4 LAs and 7 LPs) were performed in 11 patients and 47 open adrenalectomies [24 with an anterior, OA (Open anterior), approach and 23 with a posterior, OP (Open posterior), approach] in 43 patients. The LA approach showed a significantly shorter time to first oral intake (1.8 vs 3.4 days p=0.001) and postoperative hospital stay (5.5 vs 12.8 days p=0.001) compared to the OA approach. The LP approach also showed a significantly shorter time to first oral intake (0.9 vs 1.6 days p=0.046) and postoperative hospital stay (5.9 vs 9.9 days p=0.004) compared to the OP approach. There were no differences in tumor size, operation time, and postoperative complications between laparoscopic adrenalectomies and open adrenalectomies.
CONCLUSION
The laparoscopic adrenalectomy is superior to the open adrenalectomy when performed by appropriately trained and skilled surgeons.