Laparoscopic Lateral Transabdominal Adrenalectomy for Small and Medium Sized Benign Functioning Adrenal Diseases
Abstract
From October 1944 to December 2000, fifteen cases of benign functioning adrenal tumors successfully underwent laparoscopic lateral transabdominal adrenalectomies at Bangkok Metropolitan Administration (BMA) Medical College and Vajira Hospital. There were 10 women and 5 men. Their ages ranged from 30-52 years (mean 38.5 ± 5.42 years). The mean size of tumors was 2.8± 1.45 cm (range 1.3-6 cm), the mean weight of tumors was 14.88 ± 10.06 gm (range 60- 225 gm). Operative time in pheochromocytoma was not significantly longer than in aldosteronoma (147.5 vs 114.4 min, p> 0.05 ); removal of left-sided adrenals, on average, was longer but not significantly (right : left =1 26:13 1.5 min p> 0.05). Mean estimate blood loss in pheochromocytoma was significantly more than in aldosteronoma (128.3 vs 73.3ml p=0.028). There was no mortality, morbidity was encountered in only one case from specimen removal site hematoma and there was no conversion. The mean hospital stay was 3.3 ± 0.42 days (range 2- 5 days), time to return to work was 8.3± 1.6 days (range 5 - 12 days). Laparoscopic lateral transabdominal adrenalectomy is safe and effective. It reduces both hospital stay and intraoperative blood loss and promotes earlier return to work. These factors suggest that this operation should become a standard procedure for small-sized and medium-sized benign adrenal diseases in the future.
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