Laparoendoscopic single-site and conventional laparoscopic adrenalectomy: a matched case-control study

Abstract

Purpose: The purpose of this study was to describe our initial clinical experience and assess the feasibility of laparoendoscopic single-site surgery (LESS) in the treatment of benign adrenal adenoma.

Patients and methods: Nine patients undergoing LESS adrenalectomy for benign adrenal adenoma were compared with 17 patients undergoing conventional laparoscopic adrenalectomy. Controls were matched for age, sex, surgical indications, and tumor size via a statistically generated selection of all conventional laparoscopic adrenalectomies performed during the same period of time.

Results: No significant differences in the mean operative time (169 vs. 144.5 minutes, p = 0.287), blood loss (177.8 vs. 204.7 mL, p = 0.792), and postoperative hospital stay (3.2 vs. 3.5 days, p = 0.525) were observed between the LESS and conventional laparoscopy group. However, postoperative pain, as measured by the number of days of intravenous (IV) patient controlled anesthesia use, was significantly lower in the LESS group (0.9 vs. 1.9 days, p = 0.047). Perioperative complications were similar between the two groups.

Conclusions: LESS adrenalectomy for benign adrenal adenoma is comparable to the conventional laparoscopic approach with regard to the operative time, blood loss, length of hospital stay, and degree of complication, and has demonstrated more desirable cosmetic outcomes.