복강경 부신절제술과 개복 부신절제술 비교

• 영문명: Comparison of Laparoscopic and Open Adrenalectomy
• 발행기관: 대한내분비외과학회
• 저자명: 장효중 곽금희 양근호 김기환 한세환 김홍주 김영덕 Hyo-Jung Chang Geumhee Gwak Keun-Ho Yang Ki-Hwan Kim Sehwan Han Hong-Joo Kim and Young-Duck Kim
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』8권2호, 112~117쪽, 전체 6쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2008.06.30

영문 초록

Purpose: Advancements in technology and surgical skill have extended the applications of minimally invasive surgery, and various studies have suggested that laparoscopic adrenalectomy (LA) might lead to better clinical outcomes compared to open surgery. We reviewed our experience in order to evaluate the clinical outcomes of laparoscopic and open adrenalectomy (OA). Methods: We retrospectively analyzed the clinical records of 41 patients who underwent surgery for adrenal lesions between 1998 and 2006. Outcome measurements included gender, age, diagnosis, lesion size, operative time, intraoperative blood loss, procedure-related complications, time to first oral intake, and postoperative hospital stay. Results: There were 19 LAs and 22 OAs. There were no significant differences in gender, age, lesion location (right or left), comorbidity, complications, or postoperative hospital stay. The mean operative time was longer in the LA group than in the OA group (OA 215, LA 273 min, P=0.048). Resumption of oral intake occurred at 3.4 days in the OA group and at 1.9 days in the LA group (P＜0.001), and the incidence of bleeding that required transfusion was 58% in the OA group and 21% in the LA group (P=0.018). We divided the LA group into 14 pure LAs (pLA) and 5 conversions from laparoscopic procedures to open adrenalectomy (CA). Significant postoperative complications occurred in the OA, pLA, and CA groups at rates of 18%, 14%, and 80%, respectively (OA vs pLA, P=0.569 pLA vs CA, P=0.017 OA vs CA, P=0.017), and postoperative hospital stays were 11.1, 5.7, and 19.6 days for each group, respectively (OA vs pLA, P=0.005 pLA vs CA, P＜0.001 OA vs CA, P=0.025). Conclusion: Patients who underwent pLA had similar postoperative complications, but shorter hospital stays and shorter times to first oral intake compared to OA. Patients in the CA group had longer operative times, longer postoperative hospital stays, and significantly higher rates of variable complications compared to the pLA and OA groups. Careful preoperative selection of patients for LA is important to avoid unnecessary CA. (Korean J Endocrine Surg 2008;8:112-117)

키워드

복강경 부신절제술, 개복 부신절제술, 합병증,Laparoscopic Adrenalectomy, Open Adrenalectomy, Complications