title: [Clinical experience of laparoscopic adrenalectomy: the National Defense Medical College experience].
abstract: Twenty-seven laparoscopic adrenalectomies (LapAdx) were performed at the National Defense Medical College between 1999 and 2004. We evaluated the results of LapAdx (group L) compared to the results of open adrenalectomy (group O). Twenty-six of the 27 LapAdx were successfully performed, but one patient with a large pheochromocytoma required open surgey because of arterial bleeding in the renal hilus. The mean operating time in group L (185 +/- 19 min) was not significantly different from that in group O (206 +/- 13 min). The mean estimated blood loss in group L (111 +/- 61 g) was significantly lower than that in group O (308 +/- 67 g). The starting time for oral feeding and for ambulation was significantly earlier in group L than in group O. There was a major complication (intraoperative bleeding) in which a group L patient required a blood transfusion. We also compared the surgical results of 26 patients in LapAdx divided chronologically into the first half and the last half to determine the surgical skill acquired. The operating time was significantly shorter and blood loss significantly less for patients in the last half. In addition, the operating time and blood loss for the first-time LapAdx operators were comparable with those of experienced surgeons. Our results support the efficacy and the minimal invasiveness of LapAdx. The accumulated experience and knowledge regarding laparoscopic surgery in our institute were important in improving surgical procedures and results.
authors.affiliation: The Department of Urology, National Defense Medical College.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ito
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Asano
authors.forename: Makoto
authors.initials: M
authors.lastname: Sumitomo
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamanaka
authors.forename: Junichi
authors.initials: J
authors.lastname: Asakuma
authors.forename: Eiji
authors.initials: E
authors.lastname: Takahashi
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Yoshii
authors.forename: Akio
authors.initials: A
authors.lastname: Horiguchi
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Kimura
authors.forename: Akira
authors.initials: A
authors.lastname: Miyajima
authors.forename: Masamichi
authors.initials: M
authors.lastname: Hayakawa
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods* / Q000592:standards; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000592:standards; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome