Retroperitoneal adrenalectomy: open or endoscopic?
Conventional adrenalectomy requires relatively large incisions. To assess the value of retroperitoneal endoscopic adrenalectomy, a case-control study was performed comparing the endoscopic technique to conventional posterior adrenalectomy. All patients had adrenal tumors less than 7 cm in diameter. Endoscopic retroperitoneal adrenalectomy required more operative time (90 vs. 60 minutes, p < 0.0001) than the open approach but was associated with less blood loss (20 vs. 125 ml, p < 0.0001). Endoscopic adrenalectomy caused less pain postoperatively (p = 0.0005) and was associated with fewer complications (p = 0.035). The hospital stay was shorter after endoscopic adrenalectomy than after open adrenalectomy (p < 0.0001). In conclusion, we advocate endoscopic retroperitoneal adrenalectomy in patients with small adrenal tumors.
Bonjer
H J
HJ
Department of Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands.
van der Harst
E
E
Steyerberg
E W
EW
de Herder
W W
WW
Kazemier
G
G
Mohammedamin
R S
RS
Bruining
H A
HA
D000236:Adenoma / Q000601:surgery*; D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D016022:Case-Control Studies; D004724:Endoscopy; D006801:Humans; D008875:Middle Aged; D012187:Retroperitoneal Space; D012189:Retrospective Studies