Comparative Study The Clinical Value On Retroperitoneal Laparoscopic And Open Adrenalectomy For Adrenal Tumors

Objective: To evaluate the clinical value of retroperitoneal laparoscopic andcompare with open operation comprehensively and systematically in the treatment ofthe adrenal tumors, and look forward to its future development trend and applicationprospects in urology laparoscopic technology.Database and Method: Were retrospectively summarized and analyzed completeclinical data and clinical indicators. Of92cases of adrenal tumors who share thediagnosis and surgical treatment in the urology dept of the second affiliated hospital ofDalian medical university. retroperitoneal laparoscopic surgery treatment,70cases, ingroup A; Line22cases of open operation, in group B. Detailed record the basic data ofthe patients (including name, gender, age, domicile of origin, marital status, work,contact information, etc.), According to the two groups of patients, on average operationtime, intraoperative blood loss, postoperative gastrointestinal function recovery timeand postoperative hospital stay, postoperative complications, to evaluate and compareretroperitoneal laparoscopic surgery and traditional open operation in the treatment ofthe curative effect of adrenal tumors.Result: there are66cases of successful operation in group A and4cases ofmidway converted to open operation, they Were1case of adrenal gland nest of blood,laparoscopic is hard to stop bleeding,1case of diaphragmatic muscle injury,1case ofthe tumor and surrounding severe adhesion, and1case caused by centralmisidentification of adrenal vein bleeding seriously affect the surgical field. The22cases in group B were all successful. The average surgery time of group A is (103±16.7) min while (147±27.5) min in group B, there was no statistically significantdifference between them. The average intraoperative blood loss is (82.6±19.52) ml ingroup A while (182.5±36.95) ml in group B, the difference between them is statisticallysignificant. The postoperative recovery time of gastrointestinal function in group A is (1.24±0.56) d on average while (4.62±2.61) d in group B on average, two groups havestatistically significant differences. The average postoperative hospital stay is(6.31±2.58) d in group A while (9.64±3.05) d in group B. The incidence ofpostoperative complications in group is (21.42)%in group A while (27.27)%in groupB, there are statistically significant differences between them (note: when P <0.05,differences are statistically significant).80cases among them received postoperativefollow-up, time ranged from3months to4years; the clinical symptoms are partially orcompletely remised after surgery without tumor recurrence cases.Conclusions:The retrospectively compared study of the two operation methodsin the treatment for adrenal tumors indicate that retroperitoneal laparoscopic is safe andeffective as well as open adrenalectomy for adrenal tumors. And compared with thetraditional open operation, retroperitoneal laparoscopic has advantage in shortening theaverage operation time, reducing the average intraoperative blood loss; shorten thepostoperative gastrointestinal function recovery time and hospital stay, reducing theincidence of postoperative complications, etc. So, retroperitoneal laparoscopic is gettingmore and more patients and urology clinical doctor’s approval, It is gradually replacingtraditional open operation, becoming the "gold standard" of surgery treatment onadrenal tumor.