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Two Decades of Laparoscopic Adrenalectomy: 326 Procedures in a Single-Center Experience
Giovanni Lezoche1, Maddalena Baldarelli, Maria M Cappelletti Trombettoni
1Dipartimento di Chirurgia Generale, Clinica Chirurgica, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
Aim:
Aim of this study is to evaluate the results of 20-year single-center laparoscopic adrenalectomy (LA), with different transperitoneal techniques.
Materials And Methods:
Three hundred twenty-six adrenalectomies were performed from 1993 to 2013 using a transperitoneal approach through anterior access, flank access, and anterior submesocolic access (adopted by the author for left LA since 2004).
Results:
Overall 142 men and 184 women (mean age 59.3 y) underwent 196 right, 113 left, and 17 bilateral adrenalectomies. There was 1 fatal outcome (0.30%) due to sepsis. Conversion to open surgery was required in 7 patients (2.14%) for intraoperative bleeding (n=5), paroxysmal hypertension during pheochromocytoma removal (n=1), and tearing of the colon during bilateral adrenalectomy in a patient with Cushing hyperplasia (n=1).There were 15 postoperative complications (4.60%) managed conservatively.
Conclusions:
Transperitoneal LA is a safe, minimally invasive procedure ensuring early recovery. The submesocolic access is faster and minimizes surgical dissection.
