Clinical comparison of two approaches to laparoscopic adrenalectomy: transperitoneal versus retroperitoneal approach

doi:10.3877/cma.j.issn.1674-3253.2018.03.007

Abstract

Abstract:

Objective

To compare the clinical effect of two approaches to laparoscopic adrenalectomy: laparoscopic transperitoneal approach (LTA) and laparoscopic retroperitoneal adrenalectomy (LRA).

Methods

The clinical data of 89 cases underwent laparoscopic adrenalectomy from January 2012 to December 2016 in our department were retrospectively analyzed. The mean operative time, perioperative blood loss, tumor size, first oral intake and postoperative hospital stay were compared and analyzed between LTA and LRA groups

Results

LTA was performed in 42 patients and LRA in 47 patients. There was no significant difference in gender, age, history of abdominal surgery, antihypertensive medication history, preoperative blood pressure, preoperative heart rate, tumor location, clinical diagnosis and tumor size between LTA and LRA group (P>0.05). The mean operating time in LRA group was shorter than that in LTA [(78±17) min vs (90±21) min, P=0.0047)], especially for patients in the LRA group underwent right adrenalectomy [(80±14) min vs (93±10) min, P<0.001)]. However, those underwent left adrenalectomy had no significant difference between LRA group and LTA group [(84±14) min vs (87±11) min, P=0.144]. There was no significant difference in blood loss[(38±25) ml vs (44±32) ml, P=0.343] and tumor size. While there were significant differences in the average hospitalization and first oral intake between LRA and LTA (P<0.05).

Conclusion

LTA and LRA can be safe and effective. The mean operating time in PRA group was shorter than in LTA group, and the postoperative recovery in PRA was faster than that of the LTA group.

Key words: Laparoscopic, Adrenalectomy, Approach

Zhigang Li, Tao Fan, Guanghui Zang, Conghui Han, Houguang He. Clinical comparison of two approaches to laparoscopic adrenalectomy: transperitoneal versus retroperitoneal approach[J]. Chinese Journal of Endourology(Electronic Edition), 2018, 12(03): 172-176.

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Figures/Tables 2

References 27

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组别	例数	性别（例）		年龄（岁，±s）	体质量指数（kg/m²，±s）	腹部手术外伤史（例）	降压药物使用（例）
组别	例数	男	女	年龄（岁，±s）	体质量指数（kg/m²，±s）	腹部手术外伤史（例）	降压药物使用（例）
LTA	42	19	23	46±10	23.2±2.7	2	22
LRA	47	21	26	49±12	23.5±3.1	6	27
统计值		χ²=0.003		t=1.075	t=0.484	-	χ²=0.230
P值		0.958		0.285	0.630	0.273	0.632
组别	舒张压（mmHg，±s）	心率（次/min，±s）	肿瘤部位（例）		病理诊断（例）				肿瘤大小（cm，±s）
组别	舒张压（mmHg，±s）	心率（次/min，±s）	左	右	无功能腺瘤	原发性醛固酮增多症	嗜铬细胞瘤	库欣综合征	肿瘤大小（cm，±s）
LTA	85±15	77±17	26	16	16	14	4	8	2.6±1.1
LRA	81±15	77±11	25	22	18	15	6	8	2.9±1.3
统计值	t=1.229	t=0.067	χ²=0.668		χ²=0.272				t=1.168
P值	0.222	0.947	0.407		0.965				0.246

组别	例数	性别（例）		年龄（岁，±s）	体质量指数（kg/m²，±s）	腹部手术外伤史（例）	降压药物使用（例）
组别	例数	男	女	年龄（岁，±s）	体质量指数（kg/m²，±s）	腹部手术外伤史（例）	降压药物使用（例）
LTA	42	19	23	46±10	23.2±2.7	2	22
LRA	47	21	26	49±12	23.5±3.1	6	27
统计值		χ²=0.003		t=1.075	t=0.484	-	χ²=0.230
P值		0.958		0.285	0.630	0.273	0.632
组别	舒张压（mmHg，±s）	心率（次/min，±s）	肿瘤部位（例）		病理诊断（例）				肿瘤大小（cm，±s）
组别	舒张压（mmHg，±s）	心率（次/min，±s）	左	右	无功能腺瘤	原发性醛固酮增多症	嗜铬细胞瘤	库欣综合征	肿瘤大小（cm，±s）
LTA	85±15	77±17	26	16	16	14	4	8	2.6±1.1
LRA	81±15	77±11	25	22	18	15	6	8	2.9±1.3
统计值	t=1.229	t=0.067	χ²=0.668		χ²=0.272				t=1.168
P值	0.222	0.947	0.407		0.965				0.246

组别	例数	手术时间（min）		术中出血量（ml）	肿瘤大小（cm）	术后进食时间（d）	术后住院（d）
组别	例数	左侧	右侧	术中出血量（ml）	肿瘤大小（cm）	术后进食时间（d）	术后住院（d）
LTA组	42	87±11	93±10	44±32	2.6±1.8	1.49±0.72	2.7±1.0
LRA组	47	84±14	80±14	38±25	2.8±2.1	1.06±0.23	2.1±0.6
t值		1.473	5.252	0.953	0.479	3.705	2.954
P值		0.144	<0.001	0.343	0.633	<0.001	0.0044

组别	例数	手术时间（min）		术中出血量（ml）	肿瘤大小（cm）	术后进食时间（d）	术后住院（d）
组别	例数	左侧	右侧	术中出血量（ml）	肿瘤大小（cm）	术后进食时间（d）	术后住院（d）
LTA组	42	87±11	93±10	44±32	2.6±1.8	1.49±0.72	2.7±1.0
LRA组	47	84±14	80±14	38±25	2.8±2.1	1.06±0.23	2.1±0.6
t值		1.473	5.252	0.953	0.479	3.705	2.954
P值		0.144	<0.001	0.343	0.633	<0.001	0.0044

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