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Videoscopic adrenalectomy - when does retroperitoneal seem better?
Piotr Myśliwiec1, Magda Marek-Safiejko2, Jerzy Lukaszewicz1
11 Department of General and Endocrinological Surgery, Medical University of Bialystok, Poland.
Summary
The posterior retroperitoneal approach (PRA) for videoscopic adrenalectomy is associated with shorter operative times and hospital stays compared to the lateral transperitoneal approach (LTA). Both methods are safe for adrenal tumor removal.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Endocrinology
Background:
- Videoscopic adrenalectomy is standard for benign adrenal tumors.
- Lateral transperitoneal approach (LTA) and posterior retroperitoneal approach (PRA) are common methods.
- Optimal approach selection remains debated.
Purpose of the Study:
- Compare LTA and PRA for videoscopic adrenalectomy.
- Evaluate outcomes based on literature and institutional experience.
Main Methods:
- Literature review (PubMed, Cochrane 1990-present).
- Retrospective analysis of 71 videoscopic adrenalectomies (2009-2013).
- Comparison of patient/tumor characteristics, operative time, and complications.
Main Results:
- PRA (50 patients) vs. LTA (21 patients).
- PRA group: older patients, smaller tumors, less blood loss, shorter operative time.
- PRA group: shorter time to oral intake and hospital stay; no significant difference in morbidity.
Conclusions:
- Both LTA and PRA are safe and effective for videoscopic adrenalectomy.
- Approach choice depends on surgeon experience, patient factors, and tumor characteristics.
- PRA is preferred for small benign tumors; LTA is advantageous for larger, suspected malignant, or ectopic tumors.
