Evaluation of two methods of endoscopic adrenalectomy

The aim of this study was to analyse the results of minimally invasive adrenalectomy and to compare the advantages and weaknesses of two methods of operation.

The outcomes of 70 patients operated on between 2000 and 2006 because of lesions of the adrenal glands were analysed. The patients were allocated to two groups: 40 patients underwent laparoscopic adrenalectomy (group A), and 30 patients underwent retroperitoneal endoscopic adrenalectomy (group B) (1 patient had bilateral lesions of the adrenals). Blood loss during the operation, incidence of complications and conversions, duration of operation, size of tumour and patient's body mass index (BMI) were analysed.

Median tumour size was 3.49 +/- 1.27 cm (range: 2-7 cm) in group A, and 3.9 +/- 1.38 cm -(range: 1.4-6 cm) in group B. More than half of all patients (n = 38; 54.3 %) were operated on because of a non-functional adrenal adenoma. Conversion was performed on 5 patients (12.5 %) in group A and on 1 patient (3.3 %) in group B. Operation time in group A was 122 +/- 30.42 min, and in group B 135 +/- 57.05 min. The training period for laparoscopic adrenalectomy was shorter. There were no significant differences in blood loss during operation or incidence of complications. The size of the tumour and the patient's BMI did not have a statistically significant impact on the duration of operation.

Laparoscopic and retroperitoneal endoscopic adrenalectomies are of the same value in most aspects. However, the training period for laparoscopic adrenalectomy was shorter.