Comparison of Transperitoneal Versus Retroperitoneal Laparoscopic Adrenalectomy in a Prospective Randomized Study

Mohammadi-Fallah, Mohammad Reza; Mehdizadeh, Alireza; Afshin, Badalzadeh; Izadseresht, Behzad; Dadkhah, Niloofar; Barbod, Azarakhsh; Babaie, Mehdi; Hamedanchi, Sepehr

doi:10.1089/lap.2012.0301

Cited by 49 publications

(31 citation statements)

References 19 publications

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“…In several studies, no significant differences in outcome variables were noted between the laparoscopic PRA versus the “classic” laparoscopic LTA [5, 19–21]. Similar operation times were reported in early studies.…”

Section: Discussionsupporting

confidence: 55%

Laparoscopic anterior versus endoscopic posterior approach for adrenalectomy: a shift to a new golden standard?

Vrielink

Wevers

Kist

et al. 2016

Langenbecks Arch Surg

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PurposeThere has been an increased utilization of the posterior retroperitoneal approach (PRA) for adrenalectomy alongside the “classic” laparoscopic transabdominal technique (LTA). The aim of this study was to compare both procedures based on outcome variables at various ranges of tumor size.MethodsA retrospective analysis was performed on 204 laparoscopic transabdominal (UMC Groningen) and 57 retroperitoneal (UMC Utrecht) adrenalectomies between 1998 and 2013. We applied a univariate and multivariate regression analysis. Mann-Whitney and chi-squared tests were used to compare outcome variables between both approaches.ResultsBoth mean operation time and median blood loss were significantly lower in the PRA group with 102.1 (SD 33.5) vs. 173.3 (SD 59.1) minutes (p < 0.001) and 0 (0–200) vs. 50 (0–1000) milliliters (p < 0.001), respectively. The shorter operation time in PRA was independent of tumor size. Complication rates were higher in the LTA (19.1%) compared to PRA (8.8%). There was no significant difference in recovery time between both approaches.ConclusionsApplication of the PRA decreases operation time, blood loss, and complication rates compared to LTA. This might encourage institutions that use the LTA to start using PRA in patients with adrenal tumors, independent of tumor size.

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Section: Discussionsupporting

confidence: 55%

Laparoscopic anterior versus endoscopic posterior approach for adrenalectomy: a shift to a new golden standard?

Vrielink

Wevers

Kist

et al. 2016

Langenbecks Arch Surg

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“…Several operative parameters have been found to favour adrenalectomy performed via the retroperitoneal approach. These include shorter hospital stay [35363738], faster resumption of oral intake [3538], decreased analgesic requirement and postoperative pain which in turn leads to earlier ambulation [3739], shorter operative time [3739], blood loss [3839], and morbidity [40] associated with the procedure. The major benefit of the retroperitoneal approach is that with the adrenal against the ribcage at the back, there was no need to move any other organs out of the way.…”

Section: Transperitoneal Versus Retroperitoneal Adrenalectomymentioning

confidence: 99%

Robotic assisted adrenalectomy: Is it ready for prime time?

Teo

Lim

2016

Investig Clin Urol

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Adrenal surgery is undergoing continuous evolution and minimally invasive surgery is increasingly being used for the surgical management of adrenal masses. With robotic-assisted surgery being a widely accepted surgical treatment for many urological conditions such as prostate carcinoma and renal cell carcinoma, the use of the robot has been expanded to include robotic-assisted adrenalectomy, offering an alternative minimally invasive platform for adrenal surgery. We performed a literature review on robotic-assisted adrenalectomy, reviewing the current surgical techniques and perioperative outcomes.

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“…Several studies have been conducted to compare both surgical approaches. Several studies have shown that the outcomes of PRA were superior to TLA for removing adrenal tumors in terms of less blood loss and shorter operation time [9][10][11]. However, there is a lack of data regarding the comparison of the two approaches in patients with PHEO.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the retroperitoneal versus Transperitoneal laparoscopic Adrenalectomy perioperative outcomes and safety for Pheochromocytoma: a meta-analysis

Jiang

Qian

et al. 2020

BMC Surg

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Background: To compare the perioperative outcomes and safety of transperitoneal laparoscopic adrenalectomy with those of retroperitoneal laparoscopic adrenalectomy for patients with pheochromocytoma. Methods: We searched PubMed, EMBASE and the Cochrane Central Register for studies from 1999 to 2019 to assess the perioperative outcomes and safety of transperitoneal laparoscopic adrenalectomy and the retroperitoneal approach for laparoscopic adrenalectomy in patients with pheochromocytoma. After data extraction and quality assessments, we used RevMan 5.2 to pool the data. Results: Four retrospective studies were obtained in our meta-analysis. Patients who underwent retroperitoneal laparoscopic adrenalectomy were associated with shorter operative time (WMD: 34.91, 95% CI: 27.02 to 42.80, I2 = 15%; p < 0.01), less intraoperative blood loss (WMD: 139.32, 95% CI: 125.38 to 153.26, I2 = 0, p < 0.01), and a shorter hospital stay (WMD: 2, 95% CI: 1.18 to 2.82, I2 = 82%, p < 0.01) than patients who underwent transperitoneal laparoscopic adrenalectomy. No significant differences were found in the complication rate (OR: 1.58, 95% CI: 0.58 to 4.33, I 2 = 0; p = 0.38) or in the incidence of hemodynamic crisis (OR: 0.74, 95% CI: 0.19 to 2.94, p = 0.67) between the two groups. Conclusion: Retroperitoneal laparoscopic adrenalectomy could achieve better perioperative outcomes than the transperitoneal approach for patients with pheochromocytoma.

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Comparison of Transperitoneal Versus Retroperitoneal Laparoscopic Adrenalectomy in a Prospective Randomized Study

Cited by 49 publications

References 19 publications

Laparoscopic anterior versus endoscopic posterior approach for adrenalectomy: a shift to a new golden standard?

Laparoscopic anterior versus endoscopic posterior approach for adrenalectomy: a shift to a new golden standard?

Robotic assisted adrenalectomy: Is it ready for prime time?

Comparison of the retroperitoneal versus Transperitoneal laparoscopic Adrenalectomy perioperative outcomes and safety for Pheochromocytoma: a meta-analysis

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