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2008 Annual Meeting Abstracts
Comparative Analysis of Perioperative Outcomes in Patients Who Have Undergone Both Open and Laparoscopic Renal/Adrenal Surgeries
Compton J Benjamin, Mohammed A Atalla, H Brooks Hooper, Kevin B Blumenthal, W Marston Linehan, Gennady Bratslavsky, Peter A Pinto
Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
Introduction:
Patients with hereditary renal and adrenal tumors often present with multiple, metachronous, bilateral masses. We, therefore, perform organ-sparing surgery whenever possible. In recent years we have progressed from open to minimally invasive surgery. As a result, some patients have experienced both open and laparoscopic renal and adrenal surgery, which allows the opportunity to compare the perioperative outcomes of each approach.
Methods:
Ten patients underwent both laparoscopic and open renal or adrenal surgery. Perioperative outcomes, including operative time, number of tumors removed, estimated blood loss (EBL), time to advancement of diet, hospital stay, postoperative narcotic use, and surgical complications were compared.
Results:
Laparoscopic surgery showed a decreased number of tumors excised (2.38 vs. 4.89), increased operative time (460 vs. 318 mins), decreased EBL (550 vs. 1094 cc), and shorter hospital stay (2.38 vs. 7.78 days p = 0.01), but no difference in time to advancement of diet to regular (3.33 vs. 3.13 days). Narcotics use in the postoperative period was significantly lower after laparoscopic surgery (51 vs. 173.5 mg morphine equivalents p < 0.01). Three complications were identified in the open group (pleural effusion, rhabdomyolyis, and TIA) and one in the laparoscopic group (ileus).
Conclusions:
This patient cohort allows the comparison of open vs. laparoscopic surgery among individual patients. The shorter hospital stay, decreased narcotics use, and lower complication rate suggest that, if possible, laparoscopic renal and adrenal surgery is a good alternative for patients requiring multiple procedures.
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