title: A Comparison of Two Approaches to Laparoscopic Adrenalectomy: Lateral Transperitoneal Versus Posterior Retroperitoneal Approach.
abstract: BACKGROUND
  Laparoscopic adrenalectomy is the gold standard for the surgical treatment of benign adrenal masses. It is most commonly performed using the lateral transperitoneal approach (LTA) and the posterior retroperitoneal approach (PRA). The choice of the method depends on contraindications for a particular approach in an individual case and surgical experience. The objective of the article is to compare two approaches, LTA and PRA, in view of our own experience and literature review.
  
  
  OBJECTIVE
  The objective of the article is to compare two approaches, LTA and PRA, in view of our own experience and literature.
  
  
  METHODS
  The assessment involved morphological characteristics of tumors, indications for PRA and LTA, operative time, perioperative blood loss and postoperative complications.
  
  
  RESULTS
  Seventy-seven of the examined 104 laparoscopic adrenalectomies were performed retroperitoneally; 27 - transperitoneally. The mean size of tumors in PRA was 4.6 cm and in LTA 6.2 cm. The mean total operative time was 91.8 min in the case of PRA and 153.1 min in LTA. No differences in the amount of blood loss between the two approaches were recorded. The average hospitalization post PRA lasted 2.03 days and post LTA 2.67 days.
  
  
  CONCLUSIONS
  Laparoscopic adrenalectomy proves to be an effective and safe surgical technique both in the case of LTA and PRA. The technique to be used should be suited to surgical team's experience, patient's general condition and tumor size and location. In our experience, the most advantageous approach in the case of tumors of less than 7 cm is PRA.
authors.affiliation: Department of Oncological and General Urology, Bialystok Provincial Śniadecki Hospital, Poland.
authors.forename: Magda
authors.initials: M
authors.lastname: Marek-Safiejko
authors.affiliation: Department of Emergency Medicine and Disasters, Medical University of Bialystok, Poland.|Department of General and Endocrinological Surgery, Medical University of Bialystok, Poland.
authors.forename: Kamil
authors.initials: K
authors.lastname: Safiejko
authors.affiliation: Department of General and Endocrinological Surgery, Medical University of Bialystok, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Łukaszewicz
authors.affiliation: Department of General and Endocrinological Surgery, Medical University of Bialystok, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Dadan
authors.affiliation: Department of Emergency Medicine and Disasters, Medical University of Bialystok, Poland.|Department of General and Endocrinological Surgery, Medical University of Bialystok, Poland.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ładny
authors.affiliation: Department of Oncological and General Urology, Bialystok Provincial Śniadecki Hospital, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Kozłowski
authors.affiliation: Department of General and Endocrinological Surgery, Medical University of Bialystok, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Wojskowicz
authors.affiliation: Department of General and Endocrinological Surgery, Medical University of Bialystok, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Myśliwiec
mesh_terms: D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D010537:Peritoneum / Q000601:surgery*; D012187:Retroperitoneal Space / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: adrenalectomy; laparoscopic; retroperitoneal adrenalectomy; transperitoneal