Laparoscopic adrenalectomy by the lateral transperitoneal approach in patients with a history of previous abdominal surgery

Wideochir Inne Tech Maloinwazyjne. 2013 Jun;8(2):146-51. doi: 10.5114/wiitm.2011.32942. Epub 2013 Jan 21.

Abstract

Introduction: Even the half of patients undergoing laparoscopic adrenalectomy has history of previous abdominal surgeries. However, it is still uncertain if this fact has an impact on the operation itself as well as the postoperative course.

Aim: To analyze the effects of previous abdominal surgery on surgical outcomes in adrenal tumor patients subjected to laparoscopic adrenalectomy.

Material and methods: This study included 268 patients with adrenal gland tumors operated on by means of laparoscopic lateral transperitoneal adrenalectomy: 1) previously subjected to at least one abdominal surgery (group A, n = 101), or 2) with no history of previous abdominal operations (group B, n = 167).

Results: Groups A and B did not differ in terms of tumor size (p = 0.132), mean operation time (p = 0.456), mean intraoperative blood loss (p = 0.754), or perioperative complication rate (p = 0.833). Dissection of intraperitoneal adhesions was considered difficult in 32 patients from group A (31.6%) and 8 subjects from group B (4.7%, p < 0.001). Conversion was required in three subjects from group A (2.9%) and 3 patients from group B (1.8%, p = 0.529).

Conclusions: Previous abdominal surgery does not constitute a contraindication to laparoscopic transperitoneal adrenalectomy.

Keywords: adrenal tumors; laparoscopic adrenalectomy; previous surgery.