title: No outcome differences between a laparoscopic and retroperitoneoscopic approach in synchronous bilateral adrenal surgery.
abstract: BACKGROUND
  Two main approaches have been described for endoscopic adrenalectomy: the transperitoneal approach with the patient in the lateral decubitus position (LA) and the retroperitoneal approach with the patient in the prone position (ERA). The goal of the present study was to compare the results of LA and ERA for endoscopic bilateral synchronous adrenalectomy.
  
  
  METHODS
  Between 1994 and 2008, 34 patients underwent bilateral synchronous adrenalectomy in two referral centers: 20 patients underwent LA in Pisa (group A), and 14 patients underwent ERA in Halle (group B). Sex, age, preoperative diagnosis, body mass index, preoperative medical treatments, diameter of glands, blood loss, operative time, complications, conversion, intensive care unit stay, day of first oral intake, length of postoperative recovery, histology report, and outcome were analyzed.
  
  
  RESULTS
  There were 7 men and 13 women in group A and 6 men and 8 women in group B. Mean age was 48.1 years in group A and 38.9 years in group B. Body mass index was similar in the two groups. Diameters of the glands were larger in group A than in group B, at 61.1 versus 42.8 mm for the right side and 64.1 versus 37.4 mm for the left side. Mean hospital stay was longer in group B (8.2 versus 5.25 days; P = 0.002), whereas the intensive care unit stay was longer in group A (1.44 versus 1 day).
  
  
  CONCLUSIONS
  It is not possible to determine which of the two approaches is better; both are feasible, safe, and effective and patient outcomes are almost the same.
authors: Department of Surgery, University of Pisa, Pisa, Italy.
authors: Paolo
authors: P
authors: Miccoli
authors: Gabriele
authors: G
authors: Materazzi
authors: Michael
authors: M
authors: Brauckhoff
authors: Carlo Enrico
authors: CE
authors: Ambrosini
authors: Mario
authors: M
authors: Miccoli
authors: Henning
authors: H
authors: Dralle
mesh_terms: D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012187:Retroperitoneal Space; D016896:Treatment Outcome