SHORT-TERM AND LONG-TERM RESULTS OF TRANSPERITONEAL AND RETROPERITONEAL ENDOSCOPIC ADRENALECTOMY FOR HORMONE-ACTIVE TUMORS OF THE ADRENAL GLANDS

Abstract

The purpose of the present paper was to conduct a comparative study of the short-term and long-term results of transabdominal laparoscopic adrenalectomy (TLA) and retroperitoneal adrenalectomy (RPA) to develop clear indications for the use of optimal methods of endoscopic adrenalectomy. Materials and methods. A retrospective analysis of the results of endoscopic adrenalectomy was conducted in 472 patients, including 282 with hormone-active tumors of the adrenal glands, operated in 2000–2021 at the Odesa Regional Hospital (Odesa, Ukraine). The mean age of the patients was (50.7±0.6) years, with a predominance of women (65.2%). The results. The duration of surgical intervention in TLA group was (83.1±3.8) min, RPA group – (56.7±4.9) min (p<0.05). Blood loss in TLA group was (111±7) min, RPA group – (82±9) min (p<0.5). The need for conversion occurred in 8 (4.9%) cases in TLA group and in 3 (2.5%) cases in RPA group (p>0.05). Indicators of the quality of life in remote period after the operation were studied in 76 patients (43 of TLA group and 33 of RPА group). Our study proved that two years after the intervention the quality of life did not differ in patients of TLA and RPA groups (67.5 vs. 69.2 points). Better results of quality of life in RPA group are achieved in patients with smaller hormone-active tumors (r = –0.63 p < 0.05). In TLA group, the dependence of quality of life on tumor size was lower (r = –0.34 p < 0.05). Conclusions: 1. The complications rate after RPA is much lower than after TLA. 2. At the long-term period, the use of RPA is associated with a higher quality of life. 3. Retroperitoneal adrenalectomy should be recommended as the method of choice for the surgical treatment of small hormone-active adrenal tumors.