Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 5, September-October, p. 829–835

doi: 10.17219/acem/62347

Publication type: original article

Language: English

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A Comparison of Two Approaches to Laparoscopic Adrenalectomy: Lateral Transperitoneal Versus Posterior Retroperitoneal Approach

Magda Marek-Safiejko1,A,B,C,D, Kamil Safiejko2,3,A,C,D, Jerzy Łukaszewicz3,A,B, Jacek Dadan3,E, Robert J. Ładny2,3,E, Robert Kozłowski1,A, Piotr Wojskowicz3,B, Piotr Myśliwiec3,A,B,C,E,F

1 Department of Oncological and General Urology, Bialystok Provincial Śniadecki Hospital, Poland

2 Department of Emergency Medicine and Disasters, Medical University of Bialystok, Poland

3 Department of General and Endocrinological Surgery, Medical University of Bialystok, Poland

Abstract

Background. Laparoscopic adrenalectomy is the gold standard for the surgical treatment of benign adrenal masses. It is most commonly performed using the lateral transperitoneal approach (LTA) and the posterior retroperitoneal approach (PRA). The choice of the method depends on contraindications for a particular approach in an individual case and surgical experience. The objective of the article is to compare two approaches, LTA and PRA, in view of our own experience and literature review.
Objectives. The objective of the article is to compare two approaches, LTA and PRA, in view of our own experience and literature.
Material and Methods. The assessment involved morphological characteristics of tumors, indications for PRA and LTA, operative time, perioperative blood loss and postoperative complications.
Results. Seventy-seven of the examined 104 laparoscopic adrenalectomies were performed retroperitoneally; 27 – transperitoneally. The mean size of tumors in PRA was 4.6 cm and in LTA 6.2 cm. The mean total operative time was 91.8 min in the case of PRA and 153.1 min in LTA. No differences in the amount of blood loss between the two approaches were recorded. The average hospitalization post PRA lasted 2.03 days and post LTA 2.67 days.
Conclusion. Laparoscopic adrenalectomy proves to be an effective and safe surgical technique both in the case of LTA and PRA. The technique to be used should be suited to surgical team’s experience, patient’s general condition and tumor size and location. In our experience, the most advantageous approach in the case of tumors of less than 7 cm is PRA.

Key words

adrenalectomy, laparoscopic, transperitoneal, retroperitoneal adrenalectomy

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