Laparoscopic transperitoneal adrenalectomy: оur experience

Objective: to evaluate the efficiency of laparoscopic adrenalectomy (LAE) in the surgical treatment of patients with adrenal tumors.

Subjects and methods. In 2011 to 2014, the Clinic of Urology, I.I. Mechnikov North-Western State Medical University, performed LAE in 14 patients (8 men and 6 women). The patients’ mean age was 48.0±4.6 years. Right-, left-sided, and bilateral LAEs were carried out in 7, 5, and 2 cases, respectively. Thus, a total of 16 LAEs were performed in 14 patients. The indications for LAE were mainly primary and metastatic adrenal tumors in our series.

Results. The operations were successfully made in all the 14 patients. There were no conversions. Early postoperative complications, such as bleeding requiring blood transfusion, hypotension, and trocar wound infections, were not observed. The mean volume of intra- and postoperative blood losses was 160 (120-280) ml; the time of surgery was 120 (100-150) min. Postoperative analgesia was conducted within 36 (24-48) hours; intramuscular tramadol 50 mg was used twice daily. The mean time of hospitalization was 4 (3-5) days. Histological examination of the adrenal removed revealed adenocarcinoma in 13 (92.8%) patients and adenoma in 1 (7.2%) case.

Conclusion. LAE is the method of choice in the surgical treatment of patients with adrenal tumors. This operation during a laparoscopic access is as effective as open adrenalectomy and the duration of analgesia, the length of hospital stay and the duration of rehabilitation are comparatively shorter.