Laparoscopic versus open adrenalectomy: outcome in 35 consecutive patients

Abstract

Background: The use of minimally invasive techniques in the surgical treatment of adrenal masses has been used to remove a wide variety of adrenal tumors.

Aims: We have reviewed our experience with laparoscopic adrenalectomy and compared laparoscopic vs. open surgical approach.

Methods: The outcome of 35 consecutive patients who underwent adrenalectomy over a 3-year period has been analyzed retrospectively. Differences in operating time, blood loss, period of hospitalization, use of parenteral analgesia, resumption of oral feeding, complications, and time to return to normal activity after 18 coelioscopic vs. 17 open consecutive adrenalectomies have been considered.

Results: The average operative time was longer (mean 160 vs. 148 min, p = 0.48) and postoperative complications lower (4 vs. 5 cases, p =0.73), although not statistically significant, for the laparoscopic compared to the open surgical approach, whereas blood loss (30 vs. 165 ml; p = 0.01), postoperative analgesia (3.4 vs. 5.0 days, p = 0.02), time to restart oral feeding (3.0 vs. 4.7 days, p = 0.001), average time of hospitalization (4.5 vs. 9.6 days, p = 0.001), time to return to normal activity (21 vs. 37 days, p = 0.001) were all statistically significant.

Conclusions: Laparoscopic adrenalectomy can be considered the method of choice for managing almost all adrenal masses, because of its lower morbidity and shorter postoperative recovery.