Comparative study of laparoscopic and open adrenalectomy.
BACKGROUND
Laparoscopic adrenalectomy (LA) had become the preferred operation for management of adrenal neoplasm. We conducted this cohort study to evaluate the outcome of laparoscopic and open adrenalectomy (OA).


METHODS
A total of 67 patients with complete medical records were included in this study. Thirty patients underwent OA and the other 37 patients received LA. The intraoperative and perioperative data analyses focused on surgery time, blood loss, pain scale rating, resumption of oral feeding, hospital stay, complications and convalescence.


RESULTS
LA was completed in all 37 patients without conversion to OA or mortality. The surgery times (203.4 vs. 192.9, p = 0.776) were similar for both OA and LA groups. There was less blood loss in the LA group (355.0 vs. 104.0, p = 0.021). The postoperative pain scale rating was lower in the LA group (5.6 vs. 4.5 p = 0.035) as was analgesia demand (57.4 vs. 3.7, p < 0.001). Oral feeding resumed earlier in the LA group (91.7 vs. 16.4, p < 0.001) and these patients had a shorter postoperative hospital stay (8.4 vs. 3.9, p < 0.001). The complication rate in both groups was similar. In the LA group, patients with primary aldosteronism had shorter surgery times and less blood loss than patients with other tumor types (p < 0.05).


CONCLUSIONS
LA results in good surgical outcome without increased risks. We suggest that LA should be the preferred choice for management of adrenal neoplasms. We also suggest that surgeons inexperienced in LA consider beginning with a case of primary hyperaldosteronism.
Wu
Chun-Te
CT
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University. 5, Fushing Street, Gueishan Shiang, Taoyuan, Taiwan 333, ROC.
Chiang
Yang-Jen
YJ
Chou
Chien-Chung
CC
Liu
Kuan-Lin
KL
Lee
Sheng-Hui
SH
Chang
Ying-Hsu
YH
Chuang
Cheng-Keng
CK
D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery; D013997:Time Factors