[Retroperitoneal endoscopic adrenalectomy vs. conventional adrenalectomy in treatment of benign adrenal lesions--comparative analysis].
BACKGROUND
Miniinvasive adrenalectomy is considered to be the standard of care for the surgical treatment of the adrenal gland's pathology. Since the initial report of laparoscopic adrenalectomy in 1992 and of retroperitoneal endoscopic adrenalectomy in 1994, it has evolved into a feasible and safe minimally invasive procedure for benign adrenal tumors.


METHODS
Clinical characteristics and outcomes of 63 retroperitoneal endoscopic adrenalectomies (REAs) and 45 conventional adrenalectomies (CAs) from 1996 to 2004 were evaluated.


RESULTS
61 patients underwent 63 REAs. Tumor size varied from 2 to 8 cm. Median age was 48.6 years. Mean operative time was 135 min (45-240), mean intraoperative blood loss - 85 ml (30-550). The complication rate was 17.77%. Median postoperative hospital stay was 5 days (2-10). 44 patients underwent 45 conventional adenalectomies. Median age was 44.5 years (16-71). Intraoperative complication rate was 17.77%, postoperative - 22.22%, Mean operative time was 120 min (75-240). Median postoperative hospital stay was 10 days (6-21).


CONCLUSIONS
No statistically significant difference was established between mean operative times of REA- and CA-groups (p=0.91). Conventional adrenalectomy was associated with a significantly increased complication rate (p=0.009). Hospitalization was also longer after the open technique (p < 0.0001). Introduced in 1994 and displaying all advantages of minimal access surgery REA has become the standard of care for benign adrenal tumors.
Todorov
G
G
Petkov
R
R
Lukanova
Ts
Ts
Mladenovski
V
V
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D000091402:Prohibitins; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome