TY - JOUR
T1 - Endoscopic adrenalectomy: is there an optimal surgical approach? Results of a single Center case control study
AU - Lombardi, Celestino Pio
AU - Raffaelli, Marco
AU - De Crea, Carmela
AU - Sollazzi, Liliana
AU - Perilli, Valter
AU - Cazzato, Maria Teresa
AU - Bellantone, Rocco Domenico Alfonso
PY - 2008
Y1 - 2008
N2 - Background. The choice in between the laparoscopic lateral transabdominal (LTA) or the posterior
retroperitoneoscopic (PRA) approach for adrenalectomy is usually based on surgeon s preference, rather
than on objective arguments. We compared the intraoperative and postoperative outcomes of LTA and
PRA to determine whether there is a preferable approach.
Methods. Thirty-eight consecutive patients successfully underwent PRA for benign adrenal tumors #6
cm. A case-control study including 38 patients who successfully underwent LTA was performed.
Operative time, intraoperative ventilatory parameters (CO2 production [VCO2], whole body oxygen
consumption, arterial partial pressure of carbon dioxide [PaCO2], and arterial partial pressure of oxygen
[PaO2]), final histology, complications, postoperative stay, analgesic requirement, time to regain normal
bowel function, and time to return to work were recorded and compared between the 2 groups.
Results. The 2 groups did not differ in terms of operative time, analgesic requirement, time to first flatus,
complication rate, duration of postoperative stay, or final histology. Patients in the LTA group showed
significantly lower PaCO2, PaO2, and VCO2 at the end of the operation. Patients in the PRA group
experienced a significantly faster return to work.
Conclusion. No procedure can be considered preferable overall. In cases of bilateral adrenalectomy and
previous abdominal surgery, PRA may offer some advantages. Surgeon s preference and experience will
continue to guide this choice.
AB - Background. The choice in between the laparoscopic lateral transabdominal (LTA) or the posterior
retroperitoneoscopic (PRA) approach for adrenalectomy is usually based on surgeon s preference, rather
than on objective arguments. We compared the intraoperative and postoperative outcomes of LTA and
PRA to determine whether there is a preferable approach.
Methods. Thirty-eight consecutive patients successfully underwent PRA for benign adrenal tumors #6
cm. A case-control study including 38 patients who successfully underwent LTA was performed.
Operative time, intraoperative ventilatory parameters (CO2 production [VCO2], whole body oxygen
consumption, arterial partial pressure of carbon dioxide [PaCO2], and arterial partial pressure of oxygen
[PaO2]), final histology, complications, postoperative stay, analgesic requirement, time to regain normal
bowel function, and time to return to work were recorded and compared between the 2 groups.
Results. The 2 groups did not differ in terms of operative time, analgesic requirement, time to first flatus,
complication rate, duration of postoperative stay, or final histology. Patients in the LTA group showed
significantly lower PaCO2, PaO2, and VCO2 at the end of the operation. Patients in the PRA group
experienced a significantly faster return to work.
Conclusion. No procedure can be considered preferable overall. In cases of bilateral adrenalectomy and
previous abdominal surgery, PRA may offer some advantages. Surgeon s preference and experience will
continue to guide this choice.
KW - Laparoscopic adrenalectomy
KW - adrenal gland
KW - endoscopic adrenalectomy
KW - retroperitoneoscopic adrenalectomy
KW - Laparoscopic adrenalectomy
KW - adrenal gland
KW - endoscopic adrenalectomy
KW - retroperitoneoscopic adrenalectomy
UR - http://hdl.handle.net/10807/10940
U2 - 10.1016/j.surg.2008.08.025
DO - 10.1016/j.surg.2008.08.025
M3 - Article
SN - 0039-6060
VL - 144
SP - 1008
EP - 1014
JO - Surgery
JF - Surgery
ER -