복강경하 경복막 부신절제술의 임상경험

Purpose: A laparoscopic procedure is considered the treatment of choice for an adrenalectomy. We report our experience of a laparoscopic transperitoneal adrenalectomy in a series of 41 patients.<BR> Materials and Methods: Between February 1999 and September 2004, 41 consecutive patients underwent a laparoscopic transperitoneal adrenalectomy. The indications for a adrenalectomy were primary aldosteronism in 16 patients, Cushing`s syndrome in 7, pheochromocytoma in 6, nonfunctional adenoma in 5, adrenal cyst in 3, benign cystic teratoma in 2, myelolipoma in 1 and metastatic renal cell carcinoma in 1. The author analyzed the results of each operation.<BR> Results: The affected adrenal gland was successfully removed, with the exception of 3 cases. Conversion to open surgery was necessary in 3 of the pheochromocytoma patients due to massive intraoperative bleeding and severe adhesion to retroperitoneal fat. The mean operative time was 245.3 m inutes (125-420). The mean intraoperative blood loss and adrenal mass size were 189.6㎖ (20-2100) and 3.6㎝ (1.0-10.4), respectively. The mean post-operative hospital stay was 10.4 days (5-29). The mean times to oral intake and ambulation were 1.4 (1-3) and 1.0 days (1-2) after the operation, respectively. The mean number of days of analgesic administration was 2.1 (0-6). The conversion and major complication rates were 7.3 and 10.5%, respectively.<BR> Conclusions: A laparoscopic adrenalectomy is safe and effective in nearly all adrenal pathologies, with early oral intake, ambulation and a low number of days of pain control.