The Comparative Study Of Laparoscopic Versus Retroperitoneoscopic Adrenalectomy

Objective:This study retrospectively studied the clinical data of patients undergoing adrenalectomy from March 2011 to March 2016 in our department,and discussed the experience of retroperitoneal laparoscopic surgery in the treatment of adrenalectomy to explore the main points of its surgery and its clinical value and compared with traditional laparoscopic peritoneal adrenal surgery to improve the efficacy and safety of retroperitoneal laparoscopic surgery in adrenal diseases,and provide further support for surgical treatment of adrenal diseases.Materials and methods:Select the 120 cases who need adrenalectomy surgery in Urology department of Zibo mining group center hospital from March 2011?March 2016.All patients were randomly divided into 2 groups and there was no significant difference between these two groups in clinaical data and assay.All the patients had transperitoneal adrenalectomy and retroperitoneal adrenal surgery respectively.And the operation time,intraoperative blood loss,postoperative drainage situation,The average postoperative hospital stay and complications were analysised of two approaches to compare their respective advantages and disadvantages.Results:There was no significant difference between these two groups in preoperative related inspection examination and tumor diameter size.In the laparoscopic group,2 patients underwent open surgery,and 1 case of retroperitoneal laparoscopic surgery underwent open surgery due to large size of tumor and bleeding.The clinical symptoms of adrenal disease in the two groups were significantly improved from those before operation(P<0.05).The two surgical approaches were compared.The average operative time was:transperitoneal adrenalectomy and retroperitoneal adrenal(89.3 ± 17.6):(78.3 ± 15.6)min.Mean intraoperative blood loss(58.2 ± 13.9):(43.5 ± 9.3)ml.The postoperative drainage(118.3±22.1):(87.2±13.6)ml;Average gastrointestinal function recovery time(21±4.4):(12±1.3)h;The average postoperative hospital stay(6.2 ± 2.3):(4.2 ± 1.3)d.The complication rate of the abdominal surgery group was 6.9%and the complication rate of postoperative abdominal surgery group was 8.47%,retroperitoneal adrenalectomy has the advantage on operation time,amount of bleeding,gastrointestinal function recovery time and hospitalization timeConclusions:The retroperitoneal laparoscopic approach has the advantages of direct access,less organ disturbance,less incision,less bleeding,less injury,shorter operation time and quick postoperative recovery.It is safe and feasible to treat urological diseases and can be used as a treatment for urological diseases.For the large adrenal tumor,the operation space of the transperitoneal adrenalectomy is large,which can effectively avoid the injury of the viscera and it could be thought as the best available operation pathway.