title: Posterior retroperitoneoscopic adrenalectomy: lessons learned within five years.
abstract: Posterior retroperitoneoscopic adrenalectomy is one of the new endoscopic methods in endocrine surgery. In a prospective clinical study 142 posterior retroperitoneoscopic adrenalectomies (72 right, 70 left) were performed in 130 patients (52 males, 78 females, age 49.1 +/- 14.9 years). Indications were primary adrenal tumors (unilateral, n = 118; bilateral, n = 2), adrenal metastases (n = 2), and bilateral ACTH-dependent hyperplasias (n = 10). Tumor size ranged from 0.5 to 7.0 cm (mean 2.7 +/- 1.4 cm). Partial adrenalectomies were performed in 39 patients. Conversion to open posterior adrenalectomy was necessary in five patients and seven procedures (5%). Intraoperative and postoperative complications were minor and occurred in 5% and 13%, respectively. Mortality was zero. Operating time was 101 +/- 39 minutes (range 35-285 minutes) and depended on tumor type (pheochromocytoma versus others; p < 0.01), tumor size (< 3 vs. > or = 3 cm; p < 0.05), gender (p < 0.05), and extent of resection (partial versus complete, p < 0.05. Twenty-three adrenalectomies (17%) were performed within 1 hour or less. Blood loss was 54 +/- 72 ml. Consumption of analgesics was low (mean 6 mg piritramide postoperatively). Median duration of hospitalization was 3 days. Posterior retroperitoneoscopic adrenalectomy is a safe method that has become a standard procedure in endocrine surgery.
authors.affiliation: Klinik für Chirurgie und Zentrum für Minimal Invasive Chirurgie, Kliniken Essen-Mitte, Akademisches Lehrkrankenhaus der Universität Essen, Henricistrasse 92, D-45136 Essen, Germany.
authors.forename: M K
authors.initials: MK
authors.lastname: Walz
authors.forename: K
authors.initials: K
authors.lastname: Peitgen
authors.forename: M V
authors.initials: MV
authors.lastname: Walz
authors.forename: R
authors.initials: R
authors.lastname: Hoermann
authors.forename: B
authors.initials: B
authors.lastname: Saller
authors.forename: R M
authors.initials: RM
authors.lastname: Giebler
authors.forename: F
authors.initials: F
authors.lastname: Jockenhövel
authors.forename: T
authors.initials: T
authors.lastname: Philipp
authors.forename: C E
authors.initials: CE
authors.lastname: Broelsch
authors.forename: F W
authors.initials: FW
authors.lastname: Eigler
authors.forename: K
authors.initials: K
authors.lastname: Mann
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery*