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Open Access 01-08-2017 | ORIGINAL ARTICLE

Laparoscopic anterior versus endoscopic posterior approach for adrenalectomy: a shift to a new golden standard?

Authors: O. M. Vrielink, K. P. Wevers, J. W. Kist, I. H. M. Borel Rinkes, P. H. J. Hemmer, M. R. Vriens, J. de Vries, S. Kruijff

Published in: Langenbeck's Archives of Surgery | Issue 5/2017

Abstract

Purpose

There has been an increased utilization of the posterior retroperitoneal approach (PRA) for adrenalectomy alongside the “classic” laparoscopic transabdominal technique (LTA). The aim of this study was to compare both procedures based on outcome variables at various ranges of tumor size.

Methods

A retrospective analysis was performed on 204 laparoscopic transabdominal (UMC Groningen) and 57 retroperitoneal (UMC Utrecht) adrenalectomies between 1998 and 2013. We applied a univariate and multivariate regression analysis. Mann-Whitney and chi-squared tests were used to compare outcome variables between both approaches.

Results

Both mean operation time and median blood loss were significantly lower in the PRA group with 102.1 (SD 33.5) vs. 173.3 (SD 59.1) minutes (p < 0.001) and 0 (0–200) vs. 50 (0–1000) milliliters (p < 0.001), respectively. The shorter operation time in PRA was independent of tumor size. Complication rates were higher in the LTA (19.1%) compared to PRA (8.8%). There was no significant difference in recovery time between both approaches.

Conclusions

Application of the PRA decreases operation time, blood loss, and complication rates compared to LTA. This might encourage institutions that use the LTA to start using PRA in patients with adrenal tumors, independent of tumor size.

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Title: Laparoscopic anterior versus endoscopic posterior approach for adrenalectomy: a shift to a new golden standard?
Authors: O. M. Vrielink
K. P. Wevers
J. W. Kist
I. H. M. Borel Rinkes
P. H. J. Hemmer
M. R. Vriens
J. de Vries
S. Kruijff
Publication date: 01-08-2017
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 5/2017
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-016-1533-x

At a glance: The STEP trials

Springer Medicine

Laparoscopic anterior versus endoscopic posterior approach for adrenalectomy: a shift to a new golden standard?

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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