title: Two Decades of Laparoscopic Adrenalectomy: 326 Procedures in a Single-Center Experience.
abstract: OBJECTIVE
  Aim of this study is to evaluate the results of 20-year single-center laparoscopic adrenalectomy (LA), with different transperitoneal techniques.
  
  
  METHODS
  Three hundred twenty-six adrenalectomies were performed from 1993 to 2013 using a transperitoneal approach through anterior access, flank access, and anterior submesocolic access (adopted by the author for left LA since 2004).
  
  
  RESULTS
  Overall 142 men and 184 women (mean age 59.3 y) underwent 196 right, 113 left, and 17 bilateral adrenalectomies. There was 1 fatal outcome (0.30%) due to sepsis. Conversion to open surgery was required in 7 patients (2.14%) for intraoperative bleeding (n=5), paroxysmal hypertension during pheochromocytoma removal (n=1), and tearing of the colon during bilateral adrenalectomy in a patient with Cushing hyperplasia (n=1).There were 15 postoperative complications (4.60%) managed conservatively.
  
  
  CONCLUSIONS
  Transperitoneal LA is a safe, minimally invasive procedure ensuring early recovery. The submesocolic access is faster and minimizes surgical dissection.
authors.affiliation: Dipartimento di Chirurgia Generale, Clinica Chirurgica, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lezoche
authors.forename: Maddalena
authors.initials: M
authors.lastname: Baldarelli
authors.forename: Maria M
authors.initials: MM
authors.lastname: Cappelletti Trombettoni
authors.forename: Vanessa
authors.initials: V
authors.lastname: Polenta
authors.forename: Monica
authors.initials: M
authors.lastname: Ortenzi
authors.forename: Adriana
authors.initials: A
authors.lastname: Tuttolomondo
authors.forename: Mario
authors.initials: M
authors.lastname: Guerrieri
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods* / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data*; D005260:Female; D005544:Forecasting; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D055815:Young Adult