Diagnosis and Treatment of Adrenal Diseases
The efficacy and safety of posterior retroperitoneoscopic adrenalectomy in the prone position
Deng Junpeng, Que Hongliang, Li Quan, Cao Wenzhou, Shen Hua, Xie Jianjun
Published 2022-11-15
Cite as Chin J Urol, 2022, 43(11): 825-829. DOI: 10.3760/cma.j.cn112330-20210325-00151
Abstract
ObjectiveTo explore the efficacy and safety of posterior retroperitoneoscopic adrenalectomy (PRA) in the prone position.
MethodsThe clinical data of 74 patients who underwent PRA in the prone position in our hospital from January 2019 to February 2021 were reviewed. There were 36 males and 38 females, with an average age was (54.4±12.5) years old. The body mass index was (24.03±3.5) kg/m2. CT scans of the adrenal glands were performed before operation. There were 39 cases of adrenal tumors on the left side, 33 cases on the right side, and 2 cases on both sides. The diameter of adrenal tumors shown on CT was (2.4±1.3) cm. Among them, 22 cases were diagnosed of non-functional adrenal tumors, 21 cases were primary aldosteronism, 8 cases were Cushing syndrome, and 23 cases were pheochromocytoma . The PRA in the prone position were performed in all 74 patients(76 sides).
ResultsThe operation was performed successfully in all 74 patients(76 sides), of which 42 cases underwent unilateral adrenalectomy, 30 cases underwent unilateral partial adrenalectomy and 2 cases underwent bilateral adrenalectomy. The operation time was (53.2±16.1) min for 76 sides, and the time of two bilateral cases was 70 min and 115 min respectively. The median time of rainage tube indwelling was 3(0, 4) d, and the hospital stay was (4.2±0.9) d. The pathological diagnosis: there were 32 cases of adrenal cortical adenoma, 8 cases of adrenal cortical hyperplasia nodule, 5 cases of adrenal cyst, 7 cases of adrenal medullary lipoma, and 22 cases of adrenal pheochromocytoma. No adverse complications occurred during the perioperative period. The patients were followed-up for (12.5±2.7) months, and no tumor recurrence or long-term complications occurred.
ConclusionsPosterior retroperitoneoscopic adrenalectomy in the prone position has the advantages of reducing bleeding and exudation, and rapid recovery after surgery, which provides a safe and effective surgical method for the treatment of adrenal tumors.
Key words:
Adrenal gland neoplasms; Prone position; Laparoscopy surgery; Efficacy; Safety
Contributor Information
Deng Junpeng
Department of Urology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215001, China
Que Hongliang
Department of Urology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215001, China
Li Quan
Department of Urology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215001, China
Cao Wenzhou
Department of Urology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215001, China
Shen Hua
Department of Urology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215001, China
Xie Jianjun
Department of Urology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215001, China
