Resumo

HEVIA SUAREZ, Miguel et al. Transperitoneal laparoscopic adrenalectomy: results after 70 procedures. Arch. Esp. Urol. [online]. 2008, vol.61, n.5, pp.611-620. ISSN 0004-0614.

Objectives: To present our surgical ex-perience in laparoscopic adrenalectomy after 70 pro-cedures, comparing our results with the published series and analyzing the learning curve. Methods: Between June 1997 and December 2007 we performed 87 adrenalectomies (70 transperitoneal laparoscopy, 1 retroperitoneoscopy and 16 open surgery); 60% were female. Mean age was 54 years 15-80); 35 were left adrenalectomies, 33 right and one bilateral. Mean mass size was 3,7 cm (1-10). All patients were assessed regarding the following varia-bles: preoperative diagnosis, histopathology, operative time, blood loss, complications, conversion to open sur-gery and hospital stay. We compared the results of the first 40 surgical procedures (Group 1) and the last 30 (Group 2). We also compared our re-sults with published series. Mean time follow-up was 12 months (2-60). Results: The most frequent preoperative diagnoses were: active suprarenal mass (50%), incidentaloma (20%), pheochromocytoma (20%). Histopathology con-firmed 60% adenomas, 14% pheochromocytomas and 11% cortical nodular hyperplasia. Mean ope-rative time was 161 minutes (60-300). Average blood loss (hematocrit) was 5.2 (1-10). Conversion and complication rate were 8.5 and 7%, respectively. Mean hospital stay was 4 days (2-30). In group 2, only reduction on mean operative time (120 min) and hospital stay (3 days) was statistically significant. Conclusions: Transperitoneal laparoscopic adre-nalectomy is a feasible and safe procedure in urological groups with previous laparoscopic experien-ce. Our results are similar to the published series and confirm the efficacy, safety and reproducibility of this technique.

Palavras-chave : Adrenalectomy; Laparoscopic; Results; Learning curve.

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