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Lateral retroperitoneoscopic adrenalectomy for complicated adrenal tumor larger than 5 centimeters.
Chen, Wei; Lin, Wei; Han, Deng-Jun & Liang, Yong
Abstract
Background: The role of lateral retroperitoneoscopic adrenalectomy (LRA) for complicated tumor with large diameter remains
controversial, this study aimed to evaluate the effectiveness of this procedure on the management of tumor larger than 5cm in
diameter.
Methods: A retrospective comparison was conducted of 67 patients with large complicated adrenal tumor (>5cm). 41 patients
received LRA, and 26 received open adrenalectomy (OA) in our hospital between January 2011 and June 2015. Basic characteristics
regarding mean age, gender, body mass index (BMI), tumor size, tumor side, previous abdominal surgery, resection method,
pathology were preferentially analyzed. Operative indicators regarding operation time, estimated blood loss (EBL), conversion
to ICU, complications, post-operative hospitalization, duration of drain, time to first oral intake and ambulation were compared
between groups.
Results: There were no significant differences between the two groups in the basic characteristics. The mean operation time for
LRA was shorter than OA (98.7±32.3 min vs 152.7±72.3 min, P = 0.001). EBL was 31.9±20.0 ml for LRA and 590.0±1181.1 ml
for OA (P = 0.03). There was no complication in LRA group and one patient in OA group had complications, but this difference
was not significant (P = NS). The post-operative hospitalization in LRA was 7.4±2.8 days, and shorter than 9.8±2.7 days in OA
group (P = 0.00). The time to first oral intake and ambulation for LRA was shorter than OA (first oral intake, 1.9±0.8 days vs
3.1±1.3 days, P = 0.00; time to ambulation, 2.6±1.4 days vs 4.2±1.6 days, P = 0.00). While the difference between groups were
not significant in terms of ICU conversion (3/41 vs 4/26, P = NS) and duration of drain (3.9±2.2 days vs 4.7±1.9 days, P = NS).
Conclusion: Our study shows that LRA can be performed safely and effectively for complicated adrenal tumors larger than 5
cm in diameter, but it remains technically demanding.
Keywords
Retroperitoneoscopic adrenalectomy; adrenal tumor; lateral position
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