Outcomes of laparoscopic adrenalectomy vs. open adrenalectomy in two tertiary Filipino hospitals: a retrospective study
Objective: The aim of this study was to compare the eight-year experience of two tertiary centers in open and laparoscopic adrenalectomy in terms of operating time, blood loss, post-operative complications and length of hospital stay.
Methods: This is a retrospective observational study. Medical records of patients who underwent open and laparoscopic adrenalectomy in two centers between 2006 and 2014 were reviewed for preoperative data (age, sex, adrenal mass size on initial imaging), intraoperative data (operating time, estimated blood loss) and postoperative data (complications, length of hospital stay).
Results: In this study of 59 adult patients, 12 patients underwent open adrenalectomy (OA) and 46 patients underwent laparoscopic adrenalectomy (LA); one patient underwent conversion from LA to OA and was excluded. The most common indication was a nonfunctioning tumor. With regard to perioperative data, only tumor size yielded a significant difference, with smaller tumors (mean 2.39 ± 1.65 cm) subjected to LA, compared to OA (mean 4.92 ± 2.61 cm) adrenalectomy and a p value of <0.01. No significant difference was observed between the two groups in terms of operating room time, hospital stay and estimated blood loss, although the results for estimated blood loss suggested a trend toward less blood loss in the laparoscopic group (mean 48.70 ± 35.55 mL) versus the open group (average 151.67 ± 175.91 mL) with a p value of 0.068. Complication rates were not significantly different between the two groups.
Conclusion: There was no significant difference in groups who underwent laparoscopic versus open adrenalectomy in terms of age, sex, operating time, estimated blood loss, hospital stay, and complication rate, possibly reflecting both the small sample size and the learning curve of the institutions involved in training laparoscopic surgeons. Tumors subjected to open adrenalectomy were more likely to be larger. It is recommended that follow-up studies be done in order to obtain a larger and more significant sample size as well as to document the subsequent experience of the institutions involved.