Department of Digestive Surgery and Surgical Oncology - Hôpital Avicenne, Assistance Publique - Hôpitaux de Paris, Université Paris XIII, 125 Rue de Stalingrad, 93000, Bobigny, France.
World J Surg. 2019 Jul;43(7):1708-1711. doi: 10.1007/s00268-019-04954-8.
As the most appropriate laparoscopic approach for adrenalectomy is still a matter of debate, we present a modified technique of laparoscopic transmesocolic approach for left adrenalectomy.
All demographics, intraoperative and postoperative data of patients who underwent laparoscopic transmesocolic left adrenalectomy from 2009 to 2015 in Avicenne Hospital were recorded.
Thirty-three consecutive patients underwent laparoscopic transmesocolic left adrenalectomy. We observed no conversion, negligible blood loss, no red cell transfusion or intraoperative complication. Mean operative time reached 96 min (range: 40-200 min). Postoperatively, the median length of hospital stay was 5 days (range: 3-8 days), mortality was nil, and six (19%) patients suffered from complication, including one major complication (Clavien-Dindo III-IV, an abdominal collection treated with radiologic drainage). R0 resection was achieved in all patients.
Laparoscopic left adrenalectomy using semi-lateral transperitoneal transmesocolic approach is feasible and safe with acceptable intraoperative and perioperative outcomes. This technique could be considered as a routine approach and should be compared in further studies.
由于腹腔镜肾上腺切除术的最佳入路仍存在争议，我们提出了一种改良的腹腔镜经横结肠系膜入路左肾上腺切除术技术。
记录 2009 年至 2015 年在阿维森纳医院接受腹腔镜经横结肠系膜左肾上腺切除术的所有患者的人口统计学、术中及术后数据。
33 例连续患者接受了腹腔镜经横结肠系膜左肾上腺切除术。我们没有观察到转换、出血量少、无红细胞输血或术中并发症。平均手术时间达到 96 分钟（范围：40-200 分钟）。术后，中位住院时间为 5 天（范围：3-8 天），无死亡，6 例（19%）患者发生并发症，包括 1 例严重并发症（Clavien-Dindo III-IV，腹部积液采用放射引流治疗）。所有患者均达到 R0 切除。
腹腔镜半侧经腹膜外经横结肠系膜入路左肾上腺切除术具有可行性和安全性，术中及围手术期结果可接受。该技术可作为常规入路，并应在进一步的研究中进行比较。
