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

Objective:To evaluate the clinical value of retroperitoneal Laparoscopic and compare with open adrenalectomy procedures in the treatment of adrenal disorders. Methods:The clinical data of 27 cases receiving retroperitoneal Laparoscopic adrenalectomy and 50 cases receiving open adrenalectomy,we reretrospectively analyzed, from December 2002 to July 2006,we performed 27(17 women and 10 men) retroperitoneal Laparoscopic procedures for adrenal lesions in 25 patients with a mean age of 46 years(range 30 to 63).Laparoscopic adrenalectomy was performed in 1 patients with Cushing syndrome,Laparoscopic resection of adrenal pheochromocytoma in 1 patients,Open surgeries were performed in 50 cases(40women and 10 men)with a mean age of 35 years(range 2 to 69);Open procedures for adrenal lesions in 29 patients,adrenal pheochromocy to main 12 patients,adrenalectomy was performed in 3 patients with Cushing syndrome,Laparoscopic adrenal cystectomy in 1 patients,and 2 cases of paraganglioma and so on.Results:Compared with open surgery,retroperitoneal Laparoseopic except for The mean operative time,estimated mean blood loss,intraoperative need to blood transfusion cases,intraoperative bloodpresure fluctuated cases;fast time,intestinal peristalsis recover time,analgesics use after operation,postoperation pull out urethral catheters time,postoperation pull out drainage tube time,leave a sickbed time(ambulatory time),hospital stay afte operation,total cost of hospitalization were better than those in the open adrenalectomy group(P＜0.05),There was significant difference between the two groups.There was no significant difference of the mean operative time,estimated mean blood loss,intraoperative need to blood transfusion cases,intraoperative bloodpresure fluctuated cases between the two groups (P＞0.05),There was no severe complication and only 1 cases of retroperitoneal Laparoscopic conversion to open surgery,only 1 cases of retroperitoneal Laparoscopic patients receiving blood transfusion.to lose follow search for 36 cases,41 cases With a mean follow-up of 6 months.There was no recurrence of treated lesions and later complication. Conclusions:Retroperitoneal Laparoscopic procedure is a minimally invasive and more rapid recovery,Laparoscopic Surgery can be considered the preferred choice for adrenal benign lesions,especially for small adrenal benign tumors and cyst.For adrenal exploration,retroperitoneal Laparoscopic procedure may be the first methods of choice.It has been the modern Golden standard for the treatment of benign adrenal neoplasms.