복강경 부신 절제술과 개복 부신 절제술과의 비교

• Published in: Annals of surgical treatment and research Vol. 70; no. 5; pp. 363 - 369
• Main Authors: 서인영(In-Young Seo), 계봉현(Bong-Hyeon Kye), 김준기(Jun-Gi Kim), 허윤정(Youn-Jung Heo), 조현민(Hyeon-Min Cho), 박중현(Jung-Hyeon Park), 전경화(Kyung-Hwa Jun), 서영진(Young-Jin Suh), 원용성(Yong-Sung Won), 진형민(Hyung-Min Chin), 박우배(Woo-Bae Park), 전정수(Chung-Soo Chun)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.05.2006
• Subjects: 일반외과학; Adrenalectomy; 부신 절제술; 부신 종양; Laparoscopy; Adrenal neoplasm; 복강경
• ISSN: 2288-6575; 2288-6796

Purpose: The purpose of our study was to compare the outcomes of patients who had undergone a conventional open adrenalectomy (OA) with those who had undergone a laparoscopic adrenalectomy (LA). Methods: We retrospectively reviewed 66 patients who underwent an adrenalectomy between 1990 and 2005. The study group was comprised of 41 laparoscopic cases with 25 open adrenalectomy cases comprising the control group. The parameters studied included the operating times, transfusion volumes, time to resumption of a soft diet, total frequency of analgesics, time to return to free ambulation and length of hospital stay in both the OA and LA groups. Results: No mortality was observed in either the OA or LA groups. The operating times were, on average, 203.1±64.5 and 158.2±76.4 minutes in the OA and LA group, respectively (P=0.011). 10 cases in the OA group needed a transfusion (average: 438.52±687.57 ml), but two cases including one require conversion to a celiotomy, due to a right renal vein injury, needed a transfusion (average: 23.41±110.63 ml)(P=0.004). The patients of the OA and LA groups began soft diets on the 4.8±1.1 (3～7 days) and 2.7±1.5 postoperative days (1～8 days), respectively (P=0.004). Total frequencies of analgesics were 9.5±6.5 and 4.4±4.7 in the OA and LA groups, respectively (P=0.001). The times needed to return to free ambulation were 7.6±3.8 and 4.3±2.3 days in the OA and LA groups, respectively (P= 0.000). Postoperative hospital stays were 16.3±7.5 and 7.3±2.3 days in the OA and LA groups, respectively (P=0.000). Conclusion: An LA appears to be a safe and effective approach for patients with various adrenal pathologies and large sized adrenal lesions. We expect the indications for an LA may be extended to large adrenal tumors as well as primary or metastatic malignant adrenal lesions if the oncologic principles are obeyed. (J Korean Surg Soc 2006;70: 363-369) KCI Citation Count: 2