Page 39 - WJOLS - Laparoscopic Journal
P. 39

Laparoscopic Adrenalectomy: Surgical Technique

                              Table 2: Comparison outcome between laparoscopic adrenalectomy and open surgery 20
                                                            Open                Laparoscopic
                                                            group               group              P
                                                            (n = 35)            (n = 5)            value
             Mean operation time (min)                      154 (38)           175 (66)              NS
             Mean blood loss (mL)                          270 (181)           78 (108)          < 0.0001
             Mean specimen size (mm)                         28 (15)            31 (14)              NS
             Postopperative length of hospital stays (days)  26 (17)             12 (6)             0.004
             Petients with SIRS (%)                         18 (51.4)         11 (31.4)              NS
             Mean duration of SIRS (days)                   1.9 (1.0)          1.2 (0.4)            0.04
             Letest postoperative day SIRS diagnosed        1.9 (2.6)          0.7 (1.3)             NS
            Note: NS—not statistically significant; SIRS—systemic inflammatory response syndrome; Data in parentheses are standard deviations,
            unless otherwise noted.


            decrease postoperative pain, shorter length of hospital stay  10.  Suzuki K, Kageyama S, Hiranao Y. Comaparison in three surgical
            (Table 2). This is causing laparoscopic adrenalectomy   approachs to laparoscopic adrenalectomy: A nonrandomized
                                                                    background match analysis. J Urol 2001;166(2):443-38.
            become a “gold standard” for surgical management of benign  11. Gill IS, Meraney AM, Thomas J AC.Thoracoscopic trans-
            adrenal lesions. 20,21                                  diaphragmatic adrenalectomy: The initial experience. J Urol
                                                                    2001;165(6 Pt 1):1875-81.
            CONCLUSION                                          12. Raman J, Cadeddu J, Rao P. Single-incision laparoscopic surgery:
            Laparoscopic adrenalectomy is a safe and effective surgical  Initial urological experience and comparison with natural-
            technique for management for adrenal lesions. This minimally  orificetransluminal endoscopic surgery. B J Uinternational 2008;
                                                                    101:1493-96.
            invasive approach is providing benefit over open surgery.  13. Irwin B, Rao P, Stein R. LaparoendoscopicSingle Site Surgery in
            Adequate patient selection with meticulous surgical technique  Urology. Urol Clin N Am 2009;36:223-35.
            is a key to good patient outcome.                   14. Hirano D, Minei S, Yamaguchi K. Retroperitoneoscopic
                                                                    adrenalectomy for adrenal tumors via a single Large Port Journal
            REFERENCES                                              of Endourology. 2005;19(7):788-92.
                                                                15. Walz MK, Groeben H, Alesina PF. Single-Access Retro-
             1. Melman L, Matthews BD. Current trends in laparoscopic solid  peritoneoscopic adrenalectomy (SARA) Versus Conventional
                organ surgery: Spleen, adrenal, pancreas, and liver. Surg Clin  Retroperitoneoscopic Adrenalectomy(CORA): A Case-Control
                North Am 2008;88(5):1033-46.                        Study. World J Surg 2010;6.
             2. Lin DD, Loughlin KR. Diagnosis and management of surgical  16. Silvana P, Pierre A, Mitsuhiro A. Adrenalectomy using natural

                adrenal diseases. Urology 2005;66(3):476-83.        orifice translumenal endoscopic surgery (NOTES): A transvaginal
             3. Wang DS, Terashi T. Laparoscopic adrenalectomy. Urol Clin  retroperitoneal approach. Surg Oncol 2009;18(2):131-37.
                North Am 2008;35(3):351-63.                     17. Zacharopoulou C, Nassif J, Allemann P. Exploration of the
             4.  Chelouche D , Sagie B, Keidar A. Laparoscopic adrenalectomy,  retroperitoneum using the transvaginal natural orifice transluminal
                indications, technique, complications and follow-up. IMAJ 2003;  endoscopic surgery technique. J Minim Invasive Gynecol 2009;
                (5):101-04.
             5. G Guazzani, A Ceataei, F Montrisi. Laparoscopic treatment of  16(2):198-203.
                adrenal diseases: 10 years on. BJU International 2004;9(3):  18. Mikhail AA, Tolhurst SR, Orvieto MA. Open versus
                221-27.                                             laparoscopic simultaneous bilateral adrenalectomy. Urology
             6. Castillo O, Vitagliano G, Fernando P. Laparoscopic adrenalec-  2006;67:693-96.
                tomy for adrenal masses: Does size matter. Urology 2008;  19. Chan J, Meneghetti A, Meloche R. Prospective comparison of
                (71):1138-41.                                       early and late experience with laparoscopic adrenalectomy. The
             7. Mellon J, Sethi A, Sundaram C. Laparoscopic adrenalectomy:  American Journal of Surgery 191(2006);682-68.
                Surgical techniques. Urol 2008;(24):583-89.     20. Mutoh M, Takeyama K, Nishiyama N. Systemic inflammatory
             8. Kai rys J. Anterior (transabdominal) laparoscopic adrenalectomy.  response syndrome in open versus laparoscopic adrenalectomy.
                Operative techniques in general surgery 2007;9(3):104-12.  Urology 2004;64(3):422-25.
             9. Rubinstein M, Gill IS, Aron M. Prospective, randomized  21. Kwan TL, Lam CM, Yuen AW, Lo CY. Adrenalectomy in Hong
                comparison oftransperitoneal versus retroperitoneal laparoscopic  Kong: A critical review of adoption of laparoscopic approach.
                adrenalectomy. J Urol 2005;174(2):442-45.           Am J Surg 2007;194(2):153-58.









            World Journal of Laparoscopic Surgery, May-August 2010;3(2):91-97                                 97
   34   35   36   37   38   39   40   41   42   43   44