A ten-year propensity score-matched comparison of lateral transabdominal and posterior retroperitoneoscopic approaches to adrenalectomy.

BACKGROUND

Minimally invasive adrenalectomy (MIA) is mostly performed as lateral transabdominal adrenalectomy (LTA) or posterior retroperitoneoscopic adrenalectomy (PRA). This study aims to compare LTA and PRA in terms of perioperative outcomes.

METHODS

A retrospective cohort study was conducted on 225 patients who underwent MIA from 2013 to 2023. Patients were divided into two groups: LTA (n = 182) and PRA (n = 43). Propensity score matching (PSM) was used for group balancing.

RESULTS

PRA was associated with shorter operative times (p = 0.004), shorter hospital stay (p < 0.001), fewer drainage placements (p < 0.001), shorter time to catheter removal (p = 0.028), shorter time to return to oral diet (p = 0.012), and higher need for postoperative ICU stay (p = 0.001). After PSM, PRA remained associated with shorter hospital stay (p = 0.019) and lower rate of drainage placement (p < 0.001). In multivariate analysis, no factors resulted in association with postoperative complications, while BMI resulted in association with a longer hospital stay (p = 0.016).

CONCLUSION

Both LTA and PRA demonstrated comparable safety profiles. PRA, however, was associated with a shorter hospital stay and reduced drain placement frequency.