Clinical Evaluation Of Different Laparoscopic Approaches For Resection Of Large Adrenal Tumor

Objective:By analyzing the data of patients with large adrenal tumor≥6cm and comparing the clinical effects of laparoscopic transperitoneal approach and retroperitoneal approach in the resection of large adrenal tumor,we can provide certain evidence for clinical diagnosis and treatment.Methods:The clinical data of 105 patients with large adrenal tumor were retrospectively analyzed.Among them,61 patients underwent transperitoneal laparoscopic adrenal resection,including 24 cases on the left side and 37 cases on the right side.Laparoscopic retroperitoneal adrenal resection was performed in 44 cases,including 19 on the left side and 25 on the right.Compare two groups of patients with total time,intraoperative blood loss,postoperative ICU proportion,the aeration time,postoperative fever rate(38.5℃ or higher),postoperative drainage days continuously,postoperative hospital stay.Then we analyzed the data.Results:All 105 patients completed successfully,including 25 cases of myelolipoma,23 cases of pheochromocytoma,20 cases of adrenal cyst,22 cases of adrenal sebadenoma,8 cases of gangliocytoma,6 cases of schwannoma,and 1 case of caverniform hemangioma.The total operation time of the transperitoneal approach group(103.0±13.3min)was less than that of the retroperitoneal approach group(115.7±23.7min),the intraoperative blood loss(37.6±3.9ml)and the postoperative ventilation time(2.3±0.1 days)were more than those of the retroperitoneal approach group(22.0±2.1ml,1.9±0.1 days),and the difference was statistically significant(P<0.05).There was no significant difference between the two groups in the proportion of postoperative transfer to ICU,the proportion of postoperative fever(≥38.5℃),the number of days of postoperative drainage and the length of postoperative hospital stay(P>0.05).Conclusions:Laparoscopic retroperitoneal approach for resection of large adrenal tumors resulted in less intraoperative bleeding and faster postoperative recovery of intestinal function,but the operative time was relatively longer than that of the transperitoneal approach group.Both methods can safely remove large adrenal tumors,so the choice of surgical approach in clinical practice depends on the specific situation of the patient and which surgical method the surgeon is better at.