Korean J Clin Oncol.  2021 Dec;17(2):90-95. 10.14216/kjco.21014.

Initial experience with laparoscopic posterior retroperitoneal adrenalectomy in single tertiary center

• Han JH
• Lee BC
• Park YM
• Jung HJ
• Kim Di
• Choi JB

• KMID: 2524522
• DOI: http://doi.org/10.14216/kjco.21014

Abstract

Purpose
Laparoscopic posterior retroperitoneal adrenalectomy (LPRA) is a surgical method that accesses the adrenal gland through the back. The aim of this study was to report initial experience of LPRA and evaluate possibilities for surgical application.
Methods
From March 2018 to December 2019, a total of 30 consecutive patients diagnosed with adrenal tumor underwent surgical treatment at Pusan National University Hospital were enrolled. Clinicopathologic features and various peri- and postoperative parameters were analyzed by retrospective medical record review. The mean age of the patients was 48.20 ± 13.66 years.
Results
The mean body mass index (BMI) was 25.50 ± 4.30 kg/m² . Primary hyperaldosteronism was the most frequently preoperative diagnosed disease (n = 13, 43.4%), followed by adrenal incidentaloma (n = 8, 26.6%), Cushing syndrome (n = 5, 16.6%) and pheochromocytoma (n = 4, 13.3%). The mean size of postoperative adrenal tumor was 2.72 ± 1.76 cm. The mean operating time was 162 ± 58.14 minutes. Among the 30 patients, 28 patients underwent total adrenalectomy (93.3%) and two patients underwent cortical sparing adrenalectomy (6.7%). When LPRA was performed for patients with BMI > 23.16 kg/m² , the operating time was longer than the average (P = 0.016).
Conclusion
LPRA was suitable and safe for patients with benign adrenal tumors. BMI, retroperitoneal fat density and postoperative adrenal weight may be related to the operating time, so they should be considered when deciding on a surgical method for adrenalectomy.

Keyword

Adrenalectomy; Laparoscopic posterior retroperitoneal approach; Adrenal surgery; Adrenal tumor