Abstract：Objective:To evaluate the feasibility of retroperitoneal laparoscopic adrenalectomy for large (>6 cm in diameter) adrenal tumors. Methods:A retrospective review was carried out on 98 patients with large adrenal tumors who underwent retroperitoneal laparoscopic adrenalectomy in our hospital between June 2002 to June 2013. With the patients being placed in the lateral position at the uninjured side, a self-made balloon was used to dilate the retroperitoneal space. Afterwards, 3 trocars were inserted via the costal margin at the posterior axillary line and the anterior axillary line, and 2 cm above the anterior superior iliac spine at the middle axillary line to remove the tumors. After resection of the tumor, an drainage tube was indwelled. Results:The mean diameter of the tumors was (8.1±3.2) cm (range, 6.5 to 12.6 cm). Retroperitoneal laparoscopic surgery was performed successfully on 96 cases, and 2 cases were converted to open surgery in the earlier period of our experience. The mean operation time was 65 min (range, 45 to 135 min), and the mean blood loss was 80 mL (range, 50 to 700 mL). Over a mean of l8.5-month follow-up (range, 3 to 36 months) was achieved in the cases, during which 87 cases had no local recurrence. Nine cases died, of which 7 were cancer related. Conclusions:When performed by experienced surgeons, retroperitoneal laparosoopie adrenalectomy is feasible and safe for patients with large adrenal tumors (>8 cm) as long as no contraindication of the surgery is found.
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