Research On The Clinical Application Of The Anatomical Lateral Peritoneal Laparoscopic Adrenalectomy

Objective: To evaluate the value of clinical application of the anatomical lateral peritoneal laparoscopic adrenalectomy compare with the traditional laparoscopic adrenalectomy.Method:129 patients, which had adrenal tumors and the biggest diameter was less than 6cm, were admitted to a same clinical team in Department of Urology of Qilu Hospital of Shandong University from January,2007 to December,2010. All of the patients underwent lateral peritoneal laparoscopic adrenalectomy, and 55 cases underwent non-anatomical lateral peritoneal laparoscopic adrenalectomy, however,74 cases underwent anatomical lateral peritoneal laparoscopic adrenalectomy. We collected the data of the average time of operation, average volume of blood in operation, and average length of stay to do the statistical analysis.Results:Two of these 3 patients of 129 cases transferred to open surgery, because two cases of intraoperatie bleeding, and one patient with the wide conglutination in the abdominal cavity, so the data of these 3 cases were removed. The remaining 126 patients underwent successful operations and had no obvious complication.In the non-anatomical lateral peritoneal laparoscopic adrenalectomy group, the average time of the surgery was 68.75 min; the average volume of blood was 47.16ml and the average length of stay was 5.7d. In the anatomical lateral peritoneal laparoscopic adrenalectomy group, the average time of the surgery was 52.29 min; the average volume of blood was 27.70ml and the average length of stay was 5.8d. There was significant difference in the average time of the surgery of the non-anatomical group and anatomical group, t =6.23, p=0.0001. There was significant difference in the average volume of blood of both groups, t= 5.89, p=0.0001. There was no significant difference in average length of stay of both groups, t=-0.65, p= 0.52.Conclusion:1. Anatomical lateral peritoneal laparoscopic adrenalectomy has advantages of less blood, shorter operative time and safer operative procedure, therefore it has value of clinical generalization.2.Polypionia, history of previous abdominal surgery and tumor size had certain effects on the average time of surgery and volume of blood, however, there is no effects on the hospital days after the operation.3. The surgery time of left adrenal gland is longer than right adrenal gland, but there is no obvious differences of volume of blood in surgeries of right and left adrenal gland.