Kubilay DALCI, Uğur TOPAL, Ayşe Gizem ÜNAL, İsmail Cem ERAY, Orçun YALAV, Gürhan SAKMAN

Adrenal kitlelerde laparaskopik ve açık cerrahi tekniklerin sonuç açısından karşılaştırılması

Amaç: Bu çalışmada, 9 yıl içerisinde adrenal kitle nedeni ile ameliyat edilen olgularda konvansiyonel ve laparoskopik adrenalektominin sonuçlarının karşılaştırılması amaçlanmıştır.Gereç ve Yöntem: Adrenalektomi uygulanan 81 hasta çalışmaya dahil edildi. Grup 1 konvansiyonel, Grup 2 Laparaskopik cerrahi olarak hastalar iki grupa ayrıldı. İki grup, yaş, cinsiyet, vücut kitle indeksi (VKİ), Amerikan anestezistler derneği skoru (ASA), kitle lokalizasyonu, kitle büyüklüğü ve kitlenin hormonal aktivitesi, operasyon süresi, operasyonda kanama miktarı, yatış süresi, gıdaya başlama süresi, perioperatif mortalite, erken dönem komplikasyonlar ve 90 gün içinde hastaneye tekrar başvuru gibi özellikleri esas alınarak retrospektif olarak karşılaştırıldı. Bulgular: Grup 1’de 22, Grup 2’de 59 hasta mevcut idi. Gruplar arasında yaş, cinsiyet, VKİ, ASA skoru, tümör lokalizasyonu, operasyon endikasyonları, postoperatif komplikasyon, perioperatif mortalite ve 90 gün içinde tekrar başvuru açısından istatistiksel olarak anlamlı fark saptanmadı. Kitlenin hormonal aktivitesi Grup 2’de daha yüksek, boyutu ise daha küçük saptandı. Operasyon süresi (dak), ameliyatta kanama miktarı (ml), oral alım süresi (gün) ve hastanede yatış süresi (gün) Grup 1’de daha fazla ve istatiksel olarak anlamlı bulundu. Sonuç: Laparoskopik adrenalektomi uygun hastalarda, kısa operasyon süresi, az kan kaybı, oral gıdaya erken başlama süresi ve daha kısa hastanede kalış süresi gibi avantajları, ayrıca güvenli olması nedeni ile tercih edilmesi gereken cerrahi yöntem olmalıdır.

Anahtar Kelimeler:

sürrenal, laparaskopi

Comparison of laparoscopic and open surgical techniques in adrenal masses in terms of outcome

Purpose: The aim of this study was to compare the results of conventional and laparoscopic adrenalectomy in adrenal mass cases operated on during a 9-year period.Materials and Methods: A total of 81 patients who underwent adrenalectomy were included in the study. Patients were divided into two groups as; Group 1 - conventional surgery and Group 2 - laparoscopic surgery. Two groups were compared retrospectively on characteristics such as; age, sex, body mass index (BMI), American Society of Anesthesiologists' score (ASA), mass localization, mass size and hormonal activity of the mass, duration of operation, amount of bleeding in operation, duration of hospitalization, duration until food intake, perioperative mortality, early complications and readmission to hospital within 90 days. Results: There were 22 patients in Group 1 and 59 patients in Group 2. No statistically significant difference was found between the groups in terms of age, sex, BMI, ASA score, tumor localization, indications for operation, postoperative complication, perioperative mortality and re-admittance within 90 days. The hormonal activity of the mass was higher and the mass was smaller in size in Group 2. The duration of operation (min), the amount of bleeding in the operation (ml), the duration until oral intake (days) and the length of hospital stay (days) were found to be statistically significantly higher in Group 1.Conclusion: Laparoscopic adrenalectomy should be the preferred surgical method because of its short duration of operation, low blood loss, early onset of oral food intake and shorter hospital stay, as well as its safety.

Keywords:

surrenal, laparascopy,

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