Complications of laparoscopic adrenalectomy in 75 patients treated by the same surgeon

Objective: We analyzed the complications of endoscopic adrenalectomy. Metho ds: We retrospectively reviewed the operative and postoperative complicatio ns among 75 patients with adrenal tumors who underwent endoscopic adrenalec tomy by the same surgeon. Results: Five patients (6.7%) were converted to o pen surgery. Of these, there were 2 with metastatic adrenal carcinoma, and 1 with adrenal tuberculosis. A total of 21 patients (28%) had 24 complicati ons (32%). There was no mortality. As for access and pneumoperitoneum-relat ed complications, 5 cases of subcutaneous emphysema and 3 of radiating shou lder pain occurred. Intraoperative complications included 2 cases of vascul ar injury, 2 of organ injury, and 4 of massive bleeding (>500 ml). Postoper ative complications included 2 cases of mild paralytic ileus, 2 asthma, and 1 each of angina, wound infection, retroperitoneal hematoma, and contralat eral atelectasis. Except for the patients with adrenal malignancy and adren al tuberculosis, 71% of the complications occurred among the initial 25 pat ients with laparoscopic adrenalectomy and 80% occurred in the initial 10 re troperitoneoscopic patients. Conclusion: Although endoscopic adrenalectomy is a valuable alternative to open surgery, it should be done by a skilled l aparoscopist in patients with adrenal inflammatory lesions or malignancy. C areful patient selection and correct choice of surgical approach according to the tumor size and the patient's condition are the most important points for avoiding the complications of laparoscopic adrenalectomy.