title: Comparison of laparoscopic and open adrenalectomy.
abstract: This review compares the outcomes of patients who have undergone laparoscopic and open adrenalectomy. Records of all patients who underwent adrenalectomy between January 1993 and December 1996 at Cedars-Sinai Medical Center, Los Angeles, were reviewed. Ten patients underwent laparoscopic, and ten patients underwent open adrenalectomy. The average age in the laparoscopic group (LA) was 48 years (range, 23-64) and 47 years (range, 28-79) in the open group (OA). The LA had smaller tumor size (2.9 +/- 2.0 versus 6.1 +/- 2.8 cm; P = 0.01), longer operative times (164 +/- 47 versus 124 +/- 29 minutes; P = 0.03), shorter length of postsurgical stay (4.1 +/- 2.5 versus 5.9 +/- 1.1 days; P = 0.05), and fewer days of parenteral pain medication (1.9 +/- 1.8 versus 3.4 +/- 1.0 days; P = 0.04). Although the differences did not reach statistical significance, LA also had lower estimated blood loss (118 +/- 158 versus 210 +/- 172 cc; P = 0.23), less time to oral intake (1.8 +/- 2.2 versus 2.8 +/- 1.3 days; P = 0.24), and less direct cost ($3645 +/- 1502 versus $5752 +/- 2948; P = 0.07). Complications of LA included one patient who had a prolonged ileus and adrenal insufficiency and another patient who required readmission for adrenal insufficiency. Complications of OA included one patient who had a prolonged ileus and one patient who had a 20 per cent pneumothorax. Laparoscopic adrenalectomy is the preferred technique in nonmalignant adrenal lesions less than 6 cm in size.
authors.affiliation: Department of Surgery, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Korman
authors.forename: T
authors.initials: T
authors.lastname: Ho
authors.forename: J R
authors.initials: JR
authors.lastname: Hiatt
authors.forename: E H
authors.initials: EH
authors.lastname: Phillips
mesh_terms: D000236:Adenoma / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000601:surgery; D000309:Adrenal Insufficiency / Q000209:etiology; D000315:Adrenalectomy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D016063:Blood Loss, Surgical; D003480:Cushing Syndrome / Q000601:surgery; D004180:Direct Service Costs; D004435:Eating; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000601:surgery; D007415:Intestinal Obstruction / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D010673:Pheochromocytoma / Q000601:surgery; D011030:Pneumothorax / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000700:Analgesics