A comparison of open vs laparoscopic adrenalectomy

Area of Science:

• Minimally Invasive Surgery
• Surgical Outcomes
• Endocrine Surgery

Background:

• Adrenalectomy is a surgical procedure to remove one or both adrenal glands.
• Laparoscopic transabdominal adrenalectomy (LA) is a minimally invasive approach.
• Open adrenalectomy (OA) is a traditional surgical approach.

Purpose of the Study:

• To compare the outcomes of laparoscopic transabdominal adrenalectomy (LA) versus open adrenalectomy (OA).
• To evaluate operative time, blood loss, complications, and recovery metrics for both procedures.

Main Methods:

• Retrospective review of adrenalectomies performed by a single surgical team.
• Outcome measurements included operative time, blood loss, complications, hospital stay, and return to activity.
• Data from 29 adrenalectomies (17 LA, 12 OA) in 23 patients were analyzed.

Main Results:

• Laparoscopic adrenalectomy (LA) had a longer operative time (289 vs. 201 min) but resulted in significantly shorter hospital stays (3.0 vs. 7.9 days) and faster return to activity (8.9 vs. 14.6 days) compared to open adrenalectomy (OA).
• Operative blood loss and mortality were similar between groups.
• Complications occurred in 3 LA patients and 5 OA patients, with significant cardiac/respiratory issues only in the OA group.

Conclusions:

• Laparoscopic transabdominal adrenalectomy (LA) leads to improved patient recovery, including shorter hospital stays and quicker return to normal activities, despite longer operative times.
• LA is associated with fewer significant postoperative complications, particularly cardiac and respiratory issues, compared to OA.
• Complications specific to LA involved bleeding, while OA presented risks of more severe systemic complications.