title: Laparoscopic versus open posterior adrenalectomy: a case-control study of 100 patients.
abstract: BACKGROUND
  Few controlled studies have compared laparoscopic transabdominal adrenalectomy (LA) to conventional open posterior adrenalectomy (PA).
  
  
  METHODS
  Five patients have undergone successful LA at our institution between 1992 and 1996. A matched case-control study of 50 PA patients was performed during a similar time period.
  
  
  RESULTS
  Follow-up was complete in 82% of patients with a mean follow-up time of 25 months. There were no statistically significant differences between the LA and PA groups with regard to the following demographic features: age, gender, endocrine disorder, side and size of tumor, and body habitus. Statistically significant differences (p < 0.05), however, were present (LA vs PA) when we compared the following results: mean hospital stay (3.1 versus 5.7 days), narcotic equivalents (28 versus 48), return to normal activity (3.8 versus 7 weeks), patient satisfaction (9 versus 7 [scale 1 to 10, 10 being most satisfied]), late morbidity (0 versus 54%), and operating room time (167 versus 127 minutes). Median hospital charges ($7,000 versus $6,000) were slightly higher in the LA group (p = 0.05).
  
  
  CONCLUSIONS
  Although LA is technically more demanding and slightly more expensive to perform, advances appear to exist for LA with regard to patient comfort, patient satisfaction, hospital stay, and return to normal daily activities. Late incisional complications are dramatically less in the LA group.
authors.affiliation: Division of Gastroenterologic and General Surgery, Mayo Clinic Rochester, MN 55905, USA.
authors.forename: G B
authors.initials: GB
authors.lastname: Thompson
authors.forename: C S
authors.initials: CS
authors.lastname: Grant
authors.forename: J A
authors.initials: JA
authors.lastname: van Heerden
authors.forename: R T
authors.initials: RT
authors.lastname: Schlinkert
authors.forename: W F
authors.initials: WF
authors.lastname: Young
authors.forename: D R
authors.initials: DR
authors.lastname: Farley
authors.forename: D M
authors.initials: DM
authors.lastname: Ilstrup
mesh_terms: D000315:Adrenalectomy / Q000379:methods*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged