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Laparoscopic adrenalectomy. Comparison of the transperitoneal and retroperitoneal approach
O Miyake1, K Yoshimura, T Yoshioka
1Department of Urology, Osaka University Medical School, Japan. omiyake@uro.med.osaka-u.ac.jp
Objectives:
The efficacy of transperitoneal (TP) and retroperitoneal (RP) laparoscopic adrenalectomy was compared.
Methods:
Twenty-nine patients (male: 13; female: 16) with benign adrenal tumor were evaluated in this study. Seventeen were treated with the TP, and 12 with the RP approach.
Results:
Convalescence for the TP group took longer than that for the RP group and postoperative pain was stronger for the TP than the RP group, although the difference was not significant. In addition, the amount of blood loss was larger for the TP than the RP group. When the cases were divided according to site of disease, the operating time for the right side was 351 min for the TP group and 347 min for the RP group, while that for the left side was 528 min for the TP group and 267 min for the RP group.
Conclusions:
Therefore, we recently prefer the RP approach for left adrenalectomy, but consider either approach suitable for the right side. The reason for this preference is that shortening the operating time is most important, also in the case of laparoscopic adrenalectomy because of the resulting reduced blood loss and the patients' early convalescence.