Posterior Retroperitoneoscopic adrenalectomy in the prone position. Initial experience.
2021
OBJECTIVE: Transperitoneal laparoscop-
ic adrenalectomy (TLA) is considered the treatment of
choice for small and benign adrenal tumors. In the re-
cent years, posterior retroperitoneoscopic adrenalecto-
my (PRA) has gained popularity due to its advantages
over TLA, presenting a shorter surgical time and a faster
recovery without increasing complications. Conversely,
a greater learning curve is considered because the use
of a different and unusual surgical field.
MATERIAL AND METHODS: Our objective is to de-
scribe the PRA technique to ass our initial experience
evaluating its feasibility, safety and effectiveness in a prospective series of patients. A total of 11 (9 left and 2
right) PRA performed between March 2017 and Febru-
ary 2020 were analyzed.
RESULTS: Median age was 55 (36-65) years with a
median BMI of 25.69 (20.8-34.5) Kg/m2. 54.55%
had ASA≥3. 63.37% of adrenal tumors were hormonal-
ly functional. The tumor mean size was 4 cm (0.6-8) and
cortical adenoma was the predominant pathological
anatomy (72.72%). No pheochromocytoma was oper-
ated. Median operative time was 87 minutes (35-125)
with an intraoperative bleeding of 50 (0-300) mL. No
patient presented intraoperative complications or recon-
version. Median length of stay was 1 (1-6) days. Only
one patient presented postoperative complications.
CONCLUSION: The PRA is feasible, reproducible and
safe, even during the initial learning curve, presenting a
clear early recovery with a shorter surgical time
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