title: Safety and efficacy of endoscopic retroperitoneal adrenalectomy.
abstract: BACKGROUND
  Minimally invasive adrenalectomy has replaced open surgery in the treatment of benign adrenal tumours. Transperitoneal and retroperitoneal approaches have been advocated. However, long-term outcome data are rare.
  
  
  METHODS
  Over a period of 8 years, 123 patients underwent surgery for benign adrenal lesions using the endoscopic retroperitoneal approach. Data were analysed retrospectively by review of medical charts. Long-term results were obtained by sending questionnaires to patients and contacting their primary physicians.
  
  
  RESULTS
  One hundred and twenty-three patients underwent 126 endoscopic retroperitoneal adrenalectomies. Mean operating time for unilateral adrenalectomy was 115 min, whereas that for bilateral adrenalectomy was 208 min. The conversion rate was 4.8 per cent. Complications occurred after 15.9 per cent of adrenalectomies. One patient died during the postoperative period. Long-term results were obtained in 80 patients (74.8 per cent). Nine patients (11 per cent) reported chronic incisional pain and six patients (8 per cent) had chronic abdominal pain. Addisonian crisis after bilateral adrenalectomy occurred in three patients. Most patients (86 per cent) were satisfied with the cosmetic results.
  
  
  CONCLUSIONS
  Endoscopic retroperitoneal adrenalectomy is a safe and effective procedure. Long-term outcome is acceptable and the procedure has excellent cosmetic results.
authors.affiliation: Department of Surgery, Division of Endocrinology, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
authors.forename: W E J
authors.initials: WE
authors.lastname: Hanssen
authors.forename: E
authors.initials: E
authors.lastname: Kuhry
authors.forename: Y A
authors.initials: YA
authors.lastname: Casseres
authors.forename: W W
authors.initials: WW
authors.lastname: de Herder
authors.forename: E W
authors.initials: EW
authors.lastname: Steyerberg
authors.forename: H J
authors.initials: HJ
authors.lastname: Bonjer
mesh_terms: D000307:Adrenal Gland Diseases / Q000601:surgery*; D000315:Adrenalectomy / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome