Is previous same quadrant surgery a contraindication to laparoscopic adrenalectomy?
BACKGROUND
Previous abdominal surgery may present a challenge to safely completing laparoscopic adrenalectomy. We evaluated the impact of previous ipsilateral upper abdominal surgery on laparoscopic adrenalectomy outcomes.


METHODS
A retrospective analysis of prospective databases was performed for patients that underwent laparoscopic transabdominal adrenalectomy at 2 tertiary centers between 2001 and 2011. Patients with previous ipsilateral upper abdominal surgery, contralateral upper abdominal surgery, or no relevant surgery were compared.


RESULTS
Of the 217 patients, 38 (17%) had previous ipsilateral upper abdominal surgeries, 17 (8%) had contralateral upper abdominal surgeries, and 162 (75%) had no relevant surgery. Adhesions were more common in the ipsilateral upper abdominal surgery group (63% vs 24% vs 17%; P < .001). Mean operative times (173 ± 100 vs 130 ± 76 vs 149 ± 77 minutes; P = .16) and intraoperative complication rates (3% vs 0% vs 3%; P = .55) were not different. The rate of conversion to open surgery was similar for the 3 groups (11% vs 6% vs 3%; P = .08); all 4 conversions in the ipsilateral upper abdominal surgery group followed previous open procedures. Mean duration of stay and postoperative complication rates were also comparable between the 3 groups.


CONCLUSIONS
Laparoscopic adrenalectomy in patients with previous ipsilateral upper abdominal surgery is feasible and safe, with comparable outcomes to those without previous relevant surgery, including contralateral upper abdominal surgery.
Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, WI 53226, USA.
Haggi
H
Mazeh
Alexander B
AB
Froyshteter
Tracy S
TS
Wang
Amanda L
AL
Amin
Douglas B
DB
Evans
Rebecca S
RS
Sippel
Herbert
H
Chen
Tina W
TW
Yen
D000005:Abdomen / Q000601:surgery*; D000310:Adrenal Gland Neoplasms / Q000601:surgery; D000315:Adrenalectomy / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D061887:Conversion to Open Surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D055815:Young Adult