title: [LAPAROSCOPIC ADRENALECTOMY: COMPARISON OF TRANSPERITONEAL AND RETROPERITONEAL APPROACHES].
abstract: OBJECTIVE
  Laparoscopic adrenalectomy is generally performed by either a transperitoneal approach (TA) or a retroperitoneal approach (RA). However, the optimal selection criteria for each approach are unclear. We investigated the factors affecting the safety of laparoscopic adrenalectomy to evaluate the optimal criteria for each approach.
  
  
  METHODS
  In total, 149 patients who underwent laparoscopic adrenalectomy from February 1994 to July 2013 were retrospectively analyzed. We performed TA for 75 tumors in 73 patients and RA for 78 tumors in 76 patients. Patient characteristics and operative outcomes were compared between the two groups. Furthermore, operative outcomes in patients with some surgical risks were specifically compared between the two approaches.
  
  
  RESULTS
  Patient characteristics were similar between the two groups, although the patients in the RA group were significantly older than those in the TA group. Four patients with a large pheochromocytoma in the TA group had excessive blood loss and one of them was given blood transfusion. However, there was no difference in intraoperative blood loss (p = 0.091). The other serious adverse events were not observed.
  
  
  CONCLUSIONS
  The present findings suggest that both RA and TA can be effective surgical strategies, with close attention to large pheochromocytoma to avoid excessive hemorrhage.
authors.forename: Toru
authors.initials: T
authors.lastname: Sakatani
authors.forename: Koji
authors.initials: K
authors.lastname: Nishizawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakamura
authors.forename: Ryu
authors.initials: R
authors.lastname: Kimura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fukumoto
authors.forename: Homare
authors.initials: H
authors.lastname: Okazoe
authors.forename: Tomotune
authors.initials: T
authors.lastname: Toyosato
authors.forename: Koji
authors.initials: K
authors.lastname: Inoue
authors.forename: Akito
authors.initials: A
authors.lastname: Terai
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors; D055815:Young Adult