Retroperitoneoscopic adrenalectomy: lateral versus dorsal approach.
BACKGROUND
For tumours of the adrenal gland different surgical retroperitoneal approaches have been established, including the lateral and the dorsal approach. It is still unclear if the lateral or the dorsal approach should be preferred.


METHODS
A retrospective comparison between 21 patients who underwent retroperitoneoscopic adrenalectomy in lateral position (LRA) and 24 patients who underwent a retroperitoneoscopic adrenalectomy in dorsal position (DRA).


RESULTS
There were no significant differences with regard to the age, sex, tumour localisation, and the size of the tumour. The body-mass-index as well as the operation time was significantly higher of patients who underwent surgery in lateral position. Complications were comparable in both groups.


CONCLUSIONS
The dorsal and the lateral retroperitoneal approach are ideal approaches for patients having had an intraabdominal surgery before. Due to the missing intraabdominal pressure the lateral approach is advantageous for patients with high body-mass-index (>35) and is indicated for patients with a tumour >6 cm due to the small retroperitoneal space.
Agha
Ayman
A
von Breitenbuch
Philipp
P
Gahli
Nabil
N
Piso
Pompiliu
P
Schlitt
Hans J
HJ
D000310:Adrenal Gland Neoplasms / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D003480:Cushing Syndrome / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D006929:Hyperaldosteronism / Q000601:surgery; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery; D012187:Retroperitoneal Space; D012189:Retrospective Studies