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Posterior retroperitoneoscopic adrenalectomy: recommendations to implement this approach.
Georgina Ferret Granés1, Clara Gené Skrabec1, Jordi Tarascó Palomares1
1Servicio de Cirugía General y del Aparato Digestivo, Hospital Germans Trias i Pujol, Badalona, España.
Cirugia Espanola
|July 14, 2020
Summary
Posterior retroperitoneoscopic adrenalectomy is safe and effective, particularly for female patients with adrenal adenomas. This minimally invasive approach offers good outcomes and is suitable for wider implementation.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Endocrinology
Background:
- Posterior retroperitoneoscopic approach (PRA) for adrenalectomy is underutilized despite potential benefits over anterior/lateral laparoscopic methods.
- Limited data exists on patient selection criteria for implementing PRA in adrenalectomies.
Purpose of the Study:
- To identify key patient and lesion characteristics that favor the successful implementation of the posterior retroperitoneoscopic approach for adrenalectomy.
Main Methods:
- A prospective observational study involving 50 patients undergoing adrenalectomy via PRA.
- Data collected included patient demographics, lesion characteristics, operative details (time, side, size), conversion rates, complications (Clavien Dindo scale), and hospital stay.
Main Results:
- No conversions were reported in 50 adrenalectomies using PRA.
- Shorter operative times were observed in female patients and those with adrenal adenomas (p=0.002).
- A 14% complication rate was noted, predominantly Grade I (Clavien Dindo), with a median hospital stay of two days.
Conclusions:
- Retroperitoneoscopic adrenalectomy via the posterior approach is a safe, reproducible, and effective procedure.
- Female patients diagnosed with adrenal adenomas represent the most suitable cohort for initiating this technique.
