Retroperitoneoscopic adrenalectomy: lateral versus dorsal approach

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Adrenal Gland Surgery

Background:

• Established retroperitoneal surgical approaches for adrenal gland tumors include lateral and dorsal methods.
• The optimal approach between lateral and dorsal retroperitoneal adrenalectomy remains debated.

Purpose of the Study:

• To compare the outcomes of retroperitoneoscopic adrenalectomy in lateral versus dorsal positions.
• To identify potential advantages of each approach based on patient and tumor characteristics.

Main Methods:

• Retrospective analysis of 21 patients undergoing lateral retroperitoneoscopic adrenalectomy (LRA).
• Retrospective analysis of 24 patients undergoing dorsal retroperitoneoscopic adrenalectomy (DRA).
• Comparison of patient demographics, tumor characteristics, operative time, and complications between LRA and DRA groups.

Main Results:

• No significant differences observed in age, sex, tumor location, or tumor size between LRA and DRA.
• Patients undergoing LRA had a significantly higher body mass index (BMI) and longer operative times.
• Complication rates were comparable between the two surgical approaches.

Conclusions:

• Both dorsal and lateral retroperitoneal approaches are suitable for patients with prior intra-abdominal surgery.
• The lateral approach is advantageous for patients with high BMI (>35) due to lack of intra-abdominal pressure.
• The lateral approach is indicated for tumors larger than 6 cm due to limited retroperitoneal space in the dorsal position.