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Retroperitoneoscopic or laparoscopic adrenalectomy? A single-centre UK experience
Vasilis A Constantinides1, Ioannis Christakis, Philip Touska
1Department of Thyroid and Endocrine Surgery, Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London, W12 OHS, UK, vascons@doctors.org.uk.
Surgical Endoscopy
|May 28, 2013
Summary
Retroperitoneoscopic adrenalectomy (RA) offers reduced pain and shorter hospital stays compared to laparoscopic adrenalectomy (LA). RA is a valuable alternative for benign adrenal tumors, especially smaller ones.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Urology
Background:
- Laparoscopic adrenalectomy (LA) is the standard for benign adrenal tumors.
- Retroperitoneoscopic adrenalectomy (RA) is an emerging alternative technique.
- This study compares early experiences with RA versus LA.
Purpose of the Study:
- To compare the outcomes of retroperitoneoscopic adrenalectomy (RA) with laparoscopic adrenalectomy (LA).
- To evaluate operative time, recovery, complications, and pain management.
- To assess the efficacy of RA as an alternative to LA.
Main Methods:
- Retrospective review of 71 adrenalectomies (LA vs. RA) from 2010.
- Exclusion of open adrenalectomy, bilateral cases, and paraganglioma resections.
- Comparison of operative time, oral intake, complications, analgesia, and hospital stay; matched-pair analysis performed.
Main Results:
- Mean tumor size was smaller in the RA group (2.83 cm) than the LA group (4.1 cm).
- RA group showed significantly lower operative time, earlier oral intake, fewer complications, reduced analgesic needs, and shorter hospital stay.
- Matched-pair analysis confirmed RA's superiority in analgesia requirements and length of hospital stay.
Conclusions:
- Retroperitoneoscopic adrenalectomy (RA) may lead to decreased postoperative pain and shorter hospital stays.
- RA is a viable alternative to laparoscopic adrenalectomy (LA).
- RA may be superior to LA for smaller adrenal tumors.
