Central Surgical AssociationComparison of laparoscopic transabdominal lateral versus posterior retroperitoneal adrenalectomy
Section snippets
Methods
We reviewed the records of all patients undergoing laparoscopic adrenalectomy at the Cleveland Clinic, Section of Endocrine Surgery, from 1994 to 2008. Data were extracted from an Institutional Review Board-approved database. We reviewed the preoperative data with respect to patient selection. Data extracted included patient age, sex, body mass index (BMI), operative history, tumor size, side of disease, bilateral versus unilateral involvement, characteristics on computed tomography, and
Results
During the last 14 years (1994–2008), 172 laparoscopic adrenalectomies were performed in 159 patients. Of these procedures, the PR approach was used in 90 patients and the LT approach in 69. Patient and disease characteristics are shown in Table I. Age and sex distribution were not significantly different between the 2 groups. BMI was greater in the LT group (32.4 vs 28.4; P = .005).
Side of the diseased gland was similarly distributed among the 2 groups. The incidence of previous abdominal
Discussion
One year after the LT adrenalectomy was reported, Mercan et al2 described the technique performing the procedure via an PR approach using a balloon dissector to create a potential space. Our group reported subsequently a modification of the Mercan technique with the addition of percutaneous and laparoscopic intraoperative ultrasound.3 Subsequently, Walz et al6 described using greater insufflation pressures to maintain the operative fields without disturbing hemodynamic stability.
With this large
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