Laparoscopic adrenalectomy: transperitoneal lateral approach. Cases study.
OBJECTIVE
To compare the results of the laparoscopic adrenalectomy achieved with the traditional laparotomic one.


METHODS
In the period 1997-September 2004 we treated 17 patients with adrenal pathology: eight patients underwent to an open anterior transperitoneal adrenalectomy and nine patients underwent a laparoscopic adrenalectomy with lateral transperitoneal approach.


RESULTS
Among the immediate results a longer operative time was evident in the laparoscopic approach and a greater blood loss in the open approach; there were no conversions to a laparotomic procedure. In the postoperative period there were some bronchopneumonic infiltrates and some infections of the laparotomy in the open group; in the laparoscopic group there was a parietal haematomas that cleared up spontaneously, in correspondence of a trocar access.


CONCLUSIONS
Both procedures allow to achieve the complete resolution of the adrenal pathology if it is confined within the gland and no more than 8 cm. in size. The morbidity in the mininvasive approach is surely much lower than the open technique. The advantages of a laparoscopic approach can be found in a minor surgical stress. The evident datum that results from the literature analysis of the results of the the laparoscopic adrenalectomies, is the very rapid resumption of the normal activities in the postoperative course.


CONCLUSIONS
The laparoscopic adrenalectomy with lateral transperitoneal approach is a safe and efficacious procedure. Therefore, the AA can believe that the laparoscopic approach is at present the gold standard in the treatment of all benign adrenal pathologies with a no more than 8 cm. size.
Neri
Vincenzo
V
University of Foggia, Department of Surgical Sciences, Division of General Surgery. v.neri@unifg.it
Ambrosi
Antonio
A
Fersini
Alberto
A
Valentino
Tiziano Pio
TP
D000236:Adenoma / Q000601:surgery; D000306:Adrenal Cortex Neoplasms / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D018246:Adrenocortical Adenoma / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery; D012449:Safety; D013997:Time Factors; D016896:Treatment Outcome