Clinical comparison of laparoscopic adrenalectomy by external plane of perirenal fat: transperitoneal versus retroperitoneal approach

doi:10.3877/cma.j.issn.1674-3253.2019.05.013

Abstract

Abstract:

Objective

To explore the surgical techniques and clinical efficacy of adrenalectomy through the extraperitoneal approach of perirenal fat.

Methods

Clinical data of 136 patients with adrenal tumors undergoing adrenalectomy in the Third Affiliated Hospital of Sun Yat-sen University and Southern University of Science & Technology School of Medicine from January 2018 to December 2018 were retrospectively analyzed. Among them, 97 cases were treated via the extraperitoneal approach of perirenal fat and 39 patients via the retroperitoneal approach. The intraoperative and postoperative conditions of the patients were compared between two groups.

Results

All 136 patients successfully completed the surgery. In the extraperitoneal approach of perirenal fat group, the average operation time was (47±13) min and the average intraoperative blood loss was (32±9) ml, and (66±19) min and (35±11) ml in the other group. Three patients were switched to open surgery, 1 case of intraoperative blood transfusion, and 1 case of postoperative hypertensive crisis. During adrenalectomy through the extraperitoneal approach of perirenal fat, the operation time and blood loss were better compared with those in the retroperitoneal group. The trans-abdominal technique was advantageous to the retroperitoneal approach for patients with large diameter of adrenal tumors and obesity. No statistical difference was observed in surgical complications and postoperative recovery between two groups.

Conclusion

Laparoscopic adrenalectomy through the trans-abdominal and retroperitoneal approach of perirenal fat can achieve safe and satisfactory clinical efficacy.

Key words: Adrenalectomy, Anatomical plane, Laparoscopy

Baohua Luo, Yunzheng Xiao, Xiaopeng Liu, Hengjun Xiao, Mingzhao Li, Cheng Hu, Hua Wang, Yaodong Xie, Hao Zhang. Clinical comparison of laparoscopic adrenalectomy by external plane of perirenal fat: transperitoneal versus retroperitoneal approach[J]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(05): 336-340.

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Figures/Tables 5

References 16

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组别	例数	性别（例）		年龄（岁，±s）	部位（例）		肿瘤大小（cm，±s）	BMI≥30 kg/m²（例）
组别	例数	男	女	年龄（岁，±s）	左	右	肿瘤大小（cm，±s）	BMI≥30 kg/m²（例）
经腹腔组	97	45	52	39±11	59	38	4.9±2.8	29
经后腹腔组	39	18	21	40±12	20	19	3.6±1.8	3
统计值	?	χ² =0.001		t=1.786	χ² =1.040		t=2.153	-
P值	?	0.980		0.692	0.308		0.059	0.036

组别	例数	性别（例）		年龄（岁，±s）	部位（例）		肿瘤大小（cm，±s）	BMI≥30 kg/m²（例）
组别	例数	男	女	年龄（岁，±s）	左	右	肿瘤大小（cm，±s）	BMI≥30 kg/m²（例）
经腹腔组	97	45	52	39±11	59	38	4.9±2.8	29
经后腹腔组	39	18	21	40±12	20	19	3.6±1.8	3
统计值	?	χ² =0.001		t=1.786	χ² =1.040		t=2.153	-
P值	?	0.980		0.692	0.308		0.059	0.036

组别	例数	手术时间(min，±s)	出血量(ml，±s)	输血(例)	中转开放(例)	并发症(例)	术后住院时间(d，±s)
经腹腔组	97	47±13	32±90	1	2	3	4.37±1.61
经后腹腔组	39	66±19	35±11	0	1	2	4.15±1.34
统计值	?	t=4.067	t=0.016	χ²=0.769	χ²=0.337	χ² =0.152	t=0.293
P值	?	<0.001	0.283	0.740	0.640	0.629	0.794

组别	例数	手术时间(min，±s)	出血量(ml，±s)	输血(例)	中转开放(例)	并发症(例)	术后住院时间(d，±s)
经腹腔组	97	47±13	32±90	1	2	3	4.37±1.61
经后腹腔组	39	66±19	35±11	0	1	2	4.15±1.34
统计值	?	t=4.067	t=0.016	χ²=0.769	χ²=0.337	χ² =0.152	t=0.293
P值	?	<0.001	0.283	0.740	0.640	0.629	0.794

组别	例数	原发性醛固酮增多症	皮质醇增多症	嗜铬细胞瘤	无功能皮质腺瘤	其他（囊肿、皮质癌）
经腹腔	97	26	21	13	29	8
经后腹腔	39	9	7	5	13	2
χ²值	?	0.622	0.121	0.058	0.077	0.180
P值	?	0.430	0.728	0.809	0.782	0.671

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