TRANSPERITONEAL LAPAROSCOPIC VERSUS OPEN ADRENALECTOMY FOR BENIGN HYPERFUNCTIONING ADRENAL-TUMORS - A COMPARATIVE-STUDY

In our retrospective study we compare the effectiveness and safety of transperitoneal laparoscopic versus open adrenalectomy in 40 patients with benign hyperfunctioning unilateral adrenal tumors. Patients 1 to 20 underwent open adrenalectomy between July 1988 and July 1992, and p atients 21 to 40 underwent the laparoscopic procedure between Septembe r 1992 and January 1994. Student's t test for unpaired data was used t o compare intraoperative and postoperative results, and morbidity obse rved in the 2 groups. The affected adrenal gland was successfully remo ved in all cases. Mean operative time was significantly longer for lap aroscopy, although it shortened progressively due to the learning curv e effect. Blood loss was significantly less with laparoscopy, while on ly 3 patients undergoing open surgery required blood transfusions. Ove rall invasiveness and analgesic requirement were significantly lower w ith laparoscopy. The intervals to oral intake and ambulation, hospital stay and return to preoperative normal activity were shorter with lap aroscopy. Major complications were noted only in open surgery patients . At 3 months all patients in both groups were cured of the underlying adrenal disease. We conclude that transperitoneal laparoscopic adrena lectomy is equally effective and less invasive than open surgery, and that it should be considered the first choice therapy for benign hyper functioning adrenal tumors.