Comparison of Outcomes after Laparoscopic vs Posterior Retroperitoneoscopic Adrenalectomy — ASN Events

Comparison of Outcomes after Laparoscopic vs Posterior Retroperitoneoscopic Adrenalectomy (#235)

Miguel S Cabalag 1 , G Bruce Mann 1 2 3 , Sarah Price 4 , Maeve Hutchinson 4 , Julie A Miller 1 2
  1. Endocrine Surgery Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  2. Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
  3. Royal Women’s Hospital, Melbourne, Victoria, Australia
  4. Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, Australia

To compare peri- and post-operative outcomes of our first ten cases of posterior retroperitoneoscopic adrenalectomy (PRA), with our previous ten cases of laparoscopic adrenalectomy (LA).
A retrospective chart review and telephone interviews were conducted with twenty patients who underwent adrenalectomy by the same surgeon. Analgesia use, operative time, length of stay, complications, and return to activity were recorded.
Data was collected for ten PRAs and ten LAs. Age, BMI, and tumour size, were similar between the two groups. There were no conversions to open surgery, transfusions or deaths. There was one post-operative pneumonia and one incisional hernia in the LA group, and no major complications in the PRA group. PRA patients had a shorter length of stay (median 1 vs 2 days p <0.05) and a faster return to normal activity (median 4.5 vs 33 days, p <0.05) compared to LA patients. All patients were given paracetamol routinely, and opioids upon request. The mean inpatient, post-operative opioid use was lower in patients undergoing PRA compared to LA (1.25 vs 21.0 milligrams of intravenous morphine equivalent, p = 0.37). The median days on opioids was less for PRA patients compared to LA patients (0.5 vs 9. days, p <0.05).
This case series supports previous reports that PRA results in reduced post-operative analgesia use, reduced length of hospital stay and shorter period until return to regular activity when compared to the standard laparoscopic approach.

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