title: Retroperitoneoscopic adrenalectomy: lateral versus posterior approach.
abstract: OBJECTIVE
  We used a lateral or posterior approach to perform retroperitoneoscopic adrenalectomy for adrenal tumors and compared the results to determine which approach is more advantageous.
  
  
  METHODS
  We removed 42 adrenal tumors from 42 patients by retroperitoneoscopic surgery. We used the posterior approach in 17 cases and the lateral approach in 25 cases. We compared the operating time, complications, and surgical advantages for the two approaches.
  
  
  RESULTS
  The mean operating time was significantly shorter with the lateral approach, 141 +/- 64 minutes v 225 +/- 88 minutes for the posterior approach (P = 0.0019), which we believe reflects the technical advantages of the lateral approach. Complications included one case of pneumothorax and an instance of pulmonary edema in a patient with chronic renal failure using the lateral approach and one occurrence each of pneumothorax and bleeding using the posterior approach. Retroperitoneoscopic adrenalectomy could not be performed in 1 of 25 cases (4.0%) using the lateral approach and in 3 of 17 cases (17.6%) using the posterior approach.
  
  
  CONCLUSIONS
  Our series suggests that the lateral approach is preferable to the posterior approach for retroperitoneoscopic adrenalectomy.
authors.affiliation: Department of Urology and Surgery, Jichi Medical School, Minamikawachi, Tochigi, Japan. yagisawa@jichi.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Yagisawa
authors.forename: Fumio
authors.initials: F
authors.lastname: Ito
authors.forename: Nobuo
authors.initials: N
authors.lastname: Ishikawa
authors.forename: Kaoru
authors.initials: K
authors.lastname: Matsuda
authors.forename: Shiro
authors.initials: S
authors.lastname: Onitsuka
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Goya
authors.forename: Hioshi
authors.initials: H
authors.lastname: Toma
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space; D016896:Treatment Outcome