| Background and purpose:Laparoscopic adrenalectomy has become the new "gold standard" for the surgical treatment of most adrenal lesions. Benign functional or nonfunctional adrenal tumors such as cortical adenoma, primary aldosteronism, pheochromocytoma and solitary metastasis with well-controlled primary cancer are the indications. In general, the upper limit of adrenal size that is amenable to the laparoscopic approach was 6cm. This size is a comfortable cut-off because adrenal masses larger more than 6cm usually with complicated blood vessels are technically more difficult to remove and have an increased risk for malignancy. The size of adrenal masses is also an important reference to select which laparoscopic approach. Transperitoneal approach with distinct anatomic landmark, easy localization, clarity visual field is preferred for tumors more than 5 to 6cm in diameter and for functional tumors with obvious symptoms and signs, whereas the retroperitoneal approach is preferred for unilateral tumors less than 5 to 6cm in size because of the small working space.Laparoscopic adrenalectomy as a miminal-invasive alternation of open adrenalectomy with the virtue of less injury and quick recovery now has gained the enthusiasm. Since the procedure was first reported in the literature by Gagner and co-workers in 1992, laparoscopic adrenalectomy has become widely used and is now the gold standard for the treatment of most adrenal lesions. Our researches focus on evaluating the clinical value of laparoscopic adrenalectomy and comparing with open adrenalectomy to research the appropriate routes.Methods:1. Including and excluding standard:(1) Including standardChoose the cases of adrenal lesions including such as cortical adenoma, cortical hyperplasia, cyst and pheochromocytoma, and so on.(2) Excluding standardWe rule out those cases operated concomitant with other surgery (such as cholecystectomy, gynecological surgery, et al) in the case data was interfered.2. Assemble the data:(1) Between January 1994 and December 2004 data were respectively obtained on our 122 consecutive cases of laparoscopic adrenalectomy (4 patients who conversions to open adrenalectomy were not in the followed statistical data) . We gathered the detailed clinical data of these patients, including age, pathologic diagnosis, other diseases, total operation time, blood loss, size of mass, time to oral liquids, time of intravenous antibiotic, time to Indwelling urinary catheter, time of drainage, time of postoperative hospital stay, postoperative complications, preoperative and postoperative blood pressure and serum kalium.(2) Between January 1994 and December 2004 data were respectively obtained on our 118 consecutive cases of open adrenalectomy. We gathered the detailed clinical data of these patients, including age, pathologic diagnosis, other diseases, total operation time, blood loss, size of mass, time to oral liquids, time of intravenous antibiotic, time to Indwelling urinary catheter, time of drainage, time of postoperative hospital stay, postoperative complications, preoperative and postoperative blood pressure and serum kalium.3. Data analyzing:(1) We evaluated the role of the laparoscopic adrenalectomy in contrast to the open surgery by analyzing the data of the age, total operation time, blood loss, size of mass, time to oral liquids, time of intravenous antibiotic, time to Indwelling urinary catheter, time of drainage, time of postoperative hospital stay, postoperative complications.(2) All the data were analyzed by SPSS 11.0 for windows. We chose different statistical method depended on the different data information.Result:(1) Between January 1994 and December 2004 data, we treated 122 cases by laparoscopic adrenalectomy. Laparoscopic adrenalectomy was completed in 118 of 122 cases, with 4 conversions (3.4%) to open adrenalectomy. Mean patient age was 45.62±12.69 years (range 13-73 years), mean operative time was 120.25±49.79minutes (45-300min), mean mass size was 4.05±1.83cm (1-10.5cm), mean estimated blood lo...
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