Laparoscopic transperitoneal adrenalectomy: The gold standard treatment.

Abstract

Objectives: The aim of our study was to evaluate safety and outcomes of laparoscopic transperitoneal adrenalectomy in the treatment of adrenal tumors in terms of peri operative complications. Moreover we have also focused on frequency of tumors presented with adrenal masses. Study Design: Cross sectional study. Setting: Khyber Teaching Hospital, Peshawar Pakistan. Period: 20^th October 2014 to 30^th January 2018. Material and Methods: Total of 43 patients were included in study after informed consent to participate in the study. Data was collected by predesigned questionnaire and analyzed by SPSS 20. Results: A total of 43 Laparoscopic transperitoneal adrenalectomies were performed, predominantly for pheochromocytomas (19 cases). Out of all cases operated 24 laparoscopic transperitoneal adrenalectomies were performed on the right side and 19 on the left side. According to the tumor localization, the mean operative time was 90± 9.5 minutes. Intraoperative complications occurred in five cases 11.6%. The common intraoperative complication was intraoperative bleeding (9.3%). The intraoperative complication rate on the right side was 9.3% due to intra-operative hemorrhage and the corresponding rate on left was 2.3% due to inra-operative diaphragh tear. In one case (2.3%) we could not control intraoperative hemorrhage laparoscopically and it got converted to open surgery for control of bleeding, whereas rest of the three cases with intraoperative bleeding were controlled by identifying the bleeding vessel and clipping it. Post-operative complications occurred in 7 patients (16.27%). Conclusion: Laparoscopic transperitoneal Adrenalectomy is safe, feasible procedure with decrease morbidity and early post operative recovery and discharge from hospital with no mortality.