The Control Study Between Total Adrenalectomy And Partial Adrenalectomy By Retro Laparoscopic Approach

Background Object:retro laparoscopic surgery is the main therapy approach for the adrenal benign carcinomas, now the operation of the benign adrenal carcinomas is mainly the total adrenalectomy and partial adrenalectomy is little reported, the criterion of partial adrenalectomy is not clear. The purpose of auricle is to study the diffidence of these two operation styles and research the criterion of partial adrenalectomy, via comparing indicators intro and post operation,Methods:report 76 cases of patients with retro laparoscopic adrenalectomy from 2008 to 2009 (partial adrenalectomy 25cases vs. total adrenalectomy 51 cases), compare some intraoperative indicators like Operation time,blood loss, Hospitalization and Analgesic use as well as change in hormone levels and blood pressure of functional adrenal tumors after 1 day to 6-month.Results:Comparison of preoperative indicators:Partial adrenal bleeding volume and total removal of the adrenal was no significant difference in blood loss (P=0.800). Two kinds of surgical operation time was no statistically significant (P=0.580) comparison of Hospitalization and Analgesic use were no statistically significant (P>0.05).About the intraoperative complications in all case, there is no difference between the partial adrenalectomy and total adrenalectomy.while in 23 case pheochromocytomas, the partial adrenalectomy (5/8) is significant diffident with total adrenalectomy (2/15), P<0.05.Postoperative vital signs were normal, no significant difference between the two operation styles. The hormone levels of 41 functional adrenal tumors with different surgical pathological types were significantly decreased and there were significant diffident. (P<0.01) Compared between preoperative and postoperative hormone of the same pathology and different surgical, the aldosterone hormone levels was no significant difference P> 0.05, The cortical hormone level was significant diffident at 3 days after operation and relay normal at 1 week and 1 month. Pheochromocytoma hormone levels was no significant difference P> 0.05.however, there were significant difference in 41 cases of functional adrenal tumors after short-term hormone replacement therapy. The partial adrenalectomy (2/15) is significant diffident with total adrenalectomy (7/26), but there is no difference between this two operation styles, about the adjustment of blood presser, the partial adrenalectomy is the same as the total adrenalectomy.Conclusions:The total adrenalectomy and partial adrenalectomy were all removed the tumors effectively and there were no significantly diffident about the intro-results. At the moment, these two operation styles were all decrease the level of hormone significantly. And the partial adrenalectomy can delay the chance of the cortical tumor's postoperative hormone replacement therapy. On the other side, they also could decrease the level of blood presser. The pheochromocytomas adapt to execute total adrenalectomy.