Initial experience with laparoscopic posterior retroperitoneal adrenalectomy in single tertiary center

Area of Science:

• Minimally Invasive Surgery
• Endocrinology
• Surgical Oncology

Background:

• Adrenal gland tumors require surgical intervention.
• Laparoscopic posterior retroperitoneal adrenalectomy (LPRA) offers a posterior approach for adrenal gland access.
• Evaluating the initial clinical experience with LPRA is crucial for understanding its application.

Purpose of the Study:

• To report the initial experience with Laparoscopic posterior retroperitoneal adrenalectomy (LPRA).
• To evaluate the surgical applicability and outcomes of LPRA.
• To assess the safety and efficacy of LPRA in treating adrenal tumors.

Main Methods:

• Retrospective review of 30 consecutive patients undergoing LPRA from March 2018 to December 2019.
• Analysis of clinicopathologic features and perioperative parameters.
• Comparison of operative times based on Body Mass Index (BMI).

Main Results:

• The study included 30 patients with a mean age of 48.2 years and mean BMI of 25.5 kg/m².
• Common diagnoses included primary hyperaldosteronism (43.4%), adrenal incidentaloma (26.6%), Cushing syndrome (16.6%), and pheochromocytoma (13.3%).
• LPRA was performed for adrenal tumors with a mean size of 2.72 cm; operative time averaged 162 minutes, with longer durations observed in patients with BMI >23.16 kg/m² (P=0.016).

Conclusions:

• LPRA is a suitable and safe surgical method for benign adrenal tumors.
• Factors such as BMI, retroperitoneal fat density, and tumor weight may influence operative time.
• Consideration of these factors is important when selecting the optimal surgical approach for adrenalectomy.