Benefits of Transitioning from Transperitoneal Laparoscopic to Retroperitoneoscopic Adrenalectomy-a Single Center Experience

Overview

Journal Gland Surg

Publisher AME Publishing Company

Specialty Endocrinology

Date 2024 Dec 16

PMID 39678401

Authors

Joy Feka

Barbara Soliman

Melisa Arikan

Teresa Binter

Lindsay Hargitai

Christian Scheuba

Philipp Riss

Affiliations

Soon will be listed here.

Abstract

Background: Since 2017, switching from laparoscopic transabdominal adrenalectomy (LTA), posterior retroperitoneoscopic adrenalectomy (RPA) is used as standard procedure in this institution. Aim of this retrospective study was to compare both techniques regarding operative time, length of stay and safety of the procedures.

Methods: All patients operated in our institution for adrenal tumors were prospectively documented in the EUROCRINE-database and retrospectively analyzed. Sex, age, body mass index (BMI), indication, operative time, conversion and complication rates, hospital stay and tumor-size were analyzed by Z-score, chi-square test, -test, Mann-Whitney test and Pearson correlation.

Results: A total of 105 RPAs and 132 LTAs were performed in an 8-year period. No difference was seen in age, sex and tumor localization. Adenoma (n=113) and pheochromocytoma (n=64) were the most common histopathological findings. Compared to the LTA group, the RPA group had significantly shorter operative time with a median of 50 (15-380) 125 (25-420) min (P<0.001) and shorter hospital stay with a median of 3 9 days (P<0.001). The decrease of the median operative time in RPA group, visualizing the learning curve of the procedure, was from 60 min (2017) to 45 min (2020). Four conversions from RPA to open adrenalectomy had to be performed due to bleeding or adhesions, whereas 9 LTA procedures had to be converted due to bleeding (n=2), unclear anatomy (n=1), adhesions (n=1), difficult access (n=1) or planned conversion (n=4).

Conclusions: RPA could be safely introduced with reduced operative times and shorter length of hospital stay compared to LTA.

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