[Comparison of laparoscopic versus open surgery for adrenal tumor]

We performed 25 laparoscopic adrenalectomies for adrenal tumor between January 1998 and December 2000. In 23 cases, adrenal tumors were successfully removed laparoscopically, but in 2, the laparoscopic procedure was converted to open surgery because of liver injury and endoscopically uncontrolled bleeding at the renal hilum. Postoperative complications, involving retroperitoneal hematoma, hypercapnia, and wound infections, could be managed without surgical treatment. We compared laparoscopic adrenalectomy with conventional open surgery, which had been performed for 24 adrenal tumors in our clinic. The mean operative time for the laparoscopic adrenalectomy (228.8 +/- 65.5 minutes) was significantly longer than those for the open surgery (156.0 +/- 43.8 minutes). The estimated blood loss (82.3 +/- 125.4 g) was significantly less than those for the open surgery (210.8 +/- 167.7 g), and the laparoscopic adrenalectomy had significant advantages in lessening postoperative analgesic requirements, shortening postoperative recovery period, and preserving good physical appearance. Therefore, we conclude that the laparoscopic adrenalectomy is a less invasive surgery, and is acceptable as a standard operation for adrenal tumors.