Laparoscopic transperitoneal adrenalectomy v.s. posterior retroperitoneal adrenalectomy in the aspect of complete blood count

Introduction: Minimally invasive surgery is the gold standard for treatment of benign adrenal tumours up to 7–8 cm in diameter. Nowadays, two surgical approaches are performed routinely – lateral transperitoneal adrenalectomy (LTA) and posterior retroperitoneal adrenalectomy (PRA). Both methods are recognized as safe and beneficial for a patient, what can also prove the statistical analysis in the perioperative period. Aim: The aim of our work was to compare lateral transperitoneal adrenalectomy with posterior retroperitoneal adrenalectomy in the aspect of complete blood count. M aterial and Methods: Patients, who underwent videoscopic adrenalectomy in our Department from 02.2015 to 06.2018, were prospectively included to the study. The inclusion criteria was the tumour size smaller than 8cm in abdominal CT. Primary neoplasms were excluded from the study. All surgieres were carried out by one surgeon. Patients were randomized to PRA or LTA. The blood samples were collected - a day before the surgery, and a day, a week, and a month after the surgery. We assessed the rate of leucocytes, red blood cells, hemoglobin and platelets in the peripheral blood. Additionally, the volume of intraoperative blood loss was measured. Results: 77 videoscopic adrenalectomies were carried out, 33 (42,9%) – LTA, 44 (57,1%) – PRA. The average age of the patients constituted- LTA – 61.2± 8.3, PRA – 59.3±10.2. Tumour size in LTA – 4 cm, in PRA – 4.1 cm. Adrenal gland adenomas, basing on postoperative histopathological findings, were most commonly removed tumours in our study: LTA – 82%, PRA – 70%. Intraoperative blood loss was not significant in both groups. We found differences in red blood cells, leucocytes, hemoglobin and platelets rates in each group, without statistically siginificant difference in both groups. Conclusion: Basing on our work, both minimally invasive adrenalectomies are not only effective but also safe. There were not any significant differences in both groups in the aspect of complete blood count. Both approaches – PRA and LTA can be routinely performed as a treatment of benign adrenal lesions and the choice of the approach depends on surgeon’s experience.