Comparison of transperitoneal versus retroperitoneal laparoscopic adrenalectomy (adrena tumors >6 cm)
Mei Hongbing1, Liao Xinhui1, Wang Feng1, Ye Shaobo1,Chen Jianli1, Chen Jieqing1, Zhang Xintao1
1Department of Urology, the Second People's Hospital of Shenzhen, the First Affililated Hospital of Shenzhen University, Shenzhen Key Laboratory of Genitourinary Tumor, Shenzhen 518035, China
Abstract：Objective: To compare the characteristics of transperitoneal versus retroperitoneal laparoscopic adrenalectomy and investigate the approach of laparoscopic adrenalectomy (adrena tumors >6 cm). Methods: Retrospective analysis of 13 cases who underwent laparoscopic adrenalectomy from July 2012 to November 2014 was conducted. Of these cases, 7 underwent transperitoneal laparoscopic adrenalectomy and 6 retroperitoneal 1aparoscopic adrenalectomy. The mean data of tumor size, operative time, blood loss, time to ambulation, time to postoperative intake, and complications of the modalities were compared. Results: No significant differences (all P>0.05) were found in the mean data of tumor size, operative time, blood loss, complications. The indwelling time of drainage tume was shorter, the eating time was earlier, and hospital stay was shorter in retroperitoneal laparoscopic group than in transabdominal group. No recurrence was detected biochemically during a mean follow up of 12.2 months (range 1-25 months). In transperitoneal access patients, 1 case was transferred to open surgery for injury of inferior vena cava. In retroperitoneal access patients, all cases operated successfully. Conclusions: Both the transperitoneal and retropefitoneal laparoscopic approaches are feasible and safe for adrenalectomy, and two approaches have advantages and disadvantages of each. The retroperitoneal laparoscopic group had shorter recovery time than transabdominal group.
