LAPAROSCOPIC VERSUS OPEN POSTERIOR ADRENALECTOMY - A CASE-CONTROL STUDY OF 100 PATIENTS

Background, Few controlled studies have compared laparoscopic transabd ominal adrenalectomy (LA) to conventional open posterior adrenalectomy (PA). Methods. Fifty patients have undergone successful LA at our ins titution between 1992 and 1996. A matched case-control study of 50 PA patients was performed during a similar time period. Results. Follow-u p was complete in 82 % of patients with a mean follow-up time of 25 mo nths. There were no statistically significant differences between the LA and PA groups with regard to the following demographic features: ag e, gender; endocrine disorder side and size of tumor, and body habitus . Statistically significant differences (p < 0.05), however; were pres ent (LA vs PA) when we compared the following results: mean hospital s tay (3.1 versus 5.7 days), narcotic equivalents (28 versus 48), return to normal activity (3.8 versus 7 weeks), patient satisfaction (9 vers us 7 [scale 1 to 10, 10 being most satisfied]), late morbidity (0 vers us 54 %), and operating room time (167 versus 127 minutes). Median hos pital charges ($7,000 versus $6,000) were slightly higher in the LA gr oup (p = 0.05). Conclusions. Although LA is technically more demanding and slightly more expensive to perform, advantages appear to exist fo r LA with regard to patient comfort, patient satisfaction, hospital st ay, and return to normal daily activities. Late incisional complicatio ns are dramatically less in the LA group.