A COMPARISON OF OPEN VS LAPAROSCOPIC ADRENALECTOMY

Background: To compare the outcome of patients who underwent laparosco pic transabdominal adrenalectomy (LA) with those who had open adrenale ctomy (OA). Methods: A retrospective review of consecutive adrenalecto mies performed by a single surgical team at a university hospital. Out come measurements were operative time, operative blood loss, procedure -related complications, postoperative stay, and return to regular acti vity. Results: Twenty-nine adrenalectomies were done in 23 patients du ring a 54-month period. There were 12 OAs performed in nine patients a nd 17 LAs were done in 14 patients. Both groups were similar in their demographics and their indications for operation. All attempted LAs we re successfully completed. The mean operative time was longer for LA t han for OA (289 vs 201 min; p = 0.042). Resumption of oral intake (1.0 vs 3.0 days. p = 0.002), postoperative hospital stay (3.0 vs 7.9 days ; p = 0.002), and return to regular activity (8.9 vs 14.6 days; p = 0. 002) were significantly shorter after LA than after OA. There were no postoperative deaths and there was no difference in operative blood lo ss between the two groups. Procedure-related com plications occurred i n three patients having LA and in five patients having OA. Conclusions : Patients having LA had longer operative procedures but shorter hospi tal stays and faster return to normal activity than patients having OA . Procedure-related complications for LA were due to bleeding into the retroperitoneum or abdominal wall. Significant postoperative cardiac and respiratory complications occurred only in the OA group.