چکیده (انگلیسی):

Objective: We have performed laparoscopic adrenalectomy including retroperitoneoscopic
adrenalectomy via a single large port (RASLP) and conventional laparoscopic adrenalectomy
(CLA) for adrenal tumors since 1992, and report our experience to date.
Methods: The study population consisted of 134 patients who underwent laparoscopic adrenalectomy
from 1992 to 2012. Fifty-eight patients (18 aldosterone-producing adenomas, 13 adenomas
with Cushing’s syndrome, 1 adenoma with preclinical Cushing’s syndrome, and 26
nonfunctioning tumors) were treated using RASLP, and 76 patients (33 aldosterone-producing
adenomas, 17 adenomas with Cushing’s syndrome, 6 adenomas with preclinical Cushing’s syndrome,
17 pheochromocytomas, and 3 nonfunctioning tumors) were treated using CLA. Complications
were graded according to the modified Clavien system.
Results: The majority of RASLPs were performed during the 1990s, whereas all patients underwent
CLA after 2000. The mean operation times (166 vs. 205 minutes, p < 0.01) and intraoperative
estimated blood loss (85 vs. 247 mL, p < 0.01) were significantly lower in the CLA
group. Conversion to open surgery was required in three patients (5%) in the RASLP group
and five patients (7%) in the CLA group (p Z 0.73). Postoperative complications were grade 1 in three patients and grades 4 and 5 in one patient each in the RASLP group, whereas grade 2
in one patient was observed in the CLA group (p Z 0.085).
Conclusion: Although this study included biases such as different eras and indications, CLA resulted
in decreased operative times, blood loss, and postoperative complications compared
with RASLP. CLA has so far become our preferred procedure for patients with adrenal tumor
in our experience.