Laparoscopic adrenalectomy: comparison with the conventional approach

Laparoscopic adrenalectomy (LA) was performed on 14 patients with adrenal tumors. Herein we describe the laparoscopic procedure and the patients' clinical course compared with those of patients who underwent the conventional posterior or transabdominal approach (PA, TA). The 14 patients included four men and 10 women aged 28 to 69 years. Clinical diagnoses in this series were primary aldosteronism in seven patients, Cushing's adenoma in four patients, and nonfunctioning tumor in three patients. Maximum diameters of the adrenal tumors ranged from 10 to 48 mm. In all patients, the adrenal tumors were removed successfully. The mean operating time was longer for LA- than for PA- or TA-treated patients (185 versus 99 and 143 min), whereas the mean blood loss was smaller for LA- or PA-treated (92 and 126 ml) than for TA-treated patients (407 ml). The patients' postoperative condition, as assessed in terms of the number of febrile days, leucocytosis, and elevation of C-reactive protein value, was significantly better with LA. In addition, the frequency of administration of analgesics was lower and the time required until the patient could walk were shorter after LA than after PA and TA. In conclusion, laparoscopic adrenalectomy appears to be a minimally invasive and safe therapeutic option that may become a standard procedure for adrenal surgery.