Retroperitoneal endoscopic adrenalectomy vs. Conventional adrenalectomy in treatment of benign adrenal lesions: Comparative analysis

Abstract

Minimally invasive adrenalectomy is considered to be the standard of care for the surgical treatment of the adrenal gland' s pathology. Since the initial report of laparoscopic adrenalectomy in 1992 and of retroperitoneal endoscopic adrenalectomy in 1994, it has evolved into a feasible and safe minimally invasive procedure for benign adrenal tumors. Clinical characteristics and outcomes of 63 retroperitoneal endoscopic adrenalectomies (REAs) and 45 conventional adrenalectomies (CAs) from 1996 to 2004 were evaluated. 61 patients underwent 63 REAs. Tumor size varied from 2 to 8 cm. Median age was 48.6 years. Median operative time was 135 min (45-240), median intraoperative blood loss - 85 ml (30-550). The complication rate was 17.77%. Median postoperative hospital stay was 5 days (2-10). 44 patients underwent 45 conventional adenalectomies. Median age was 44.5 years (16-71). Intraoperative complication rate was 17.77%, postoperative -22.22 %, Median operative time was 120 min (75-240). Median postoperative hospital stay was 10 days (6-21). No statistically significant difference was established between median operative times of REA- and CA-groups (p=0.91). Conventional adrenalectomy was associated with a significantly increased complication rate (p= 0.009). Hospitalization was also longer after the open tecnique (d). Introduced in 1994 and displaying all advantages of minimal access surgery REA has become the standard of care for benign adrenal tumors.

Subcostal Port Placement for Lateral Transperitoneoscopic Adrenalectomy: Assessment of Surgical Efficacy

“…Since laparoscopic adrenalectomy was first described in 1992 by Gagner et al [1], this minimally invasive procedure has replaced open adrenalectomy as the standard operation for benign adrenal disease over the last two decades [2][3][4]. Although less invasive approaches, such as single-site access, natural orifice transluminal endoscopic surgery (NOTES) and robotic-assisted surgery, have been developed, several limitations, including further refinements in instrumentation and operative techniques, hamper the broad acceptance of these new techniques [14][15][16].…”

“…Since laparoscopic adrenalectomy was first described in 1992 [1], several studies have demonstrated that this minimally invasive procedure can achieve the same results as open surgical procedures with less trauma and lower mortality [2][3][4]. At present, it has been considered the gold standard for the treatment of benign adrenal disease [5].…”