Comparison of adrenal vein control methods in laparoscopic adrenalectomy

INTRODUCTION: The aim of the present study was to compare different methods of adrenal vein control in patients undergoing laparoscopic adrenalectomy.
METHODS: Total of 87 patients who underwent laparoscopic adrenalectomy (transperitoneal, n=61; retroperitoneal, n=26) due to adrenal mass were included in this study. Mean age was 50.9 years. In 57 patients (65.5%), adrenal vein was controlled using Hem-o-lok (Teleflex, Inc., Wayne, PA, USA) ligation clip, and in remainder (n=30; 34.5%), adrenal vein was controlled using LigaSure (Medtronic, Inc., Minneapolis, MN, USA) vessel sealing system (Group 2).
RESULTS: Mean age of the patients in Group 1 and Group 2 was 52.7±4.5 years and 54.4±4.0 years, respectively (p=0.264). Mean diameter of lesion was 42.7±2.2 mm (range: 21-87 mm) and 37.5±3.6 mm (range: 15-72 mm) in Group 1 and 2, respectively (p<0.001). Mean operating time was 97.5±5.8 minutes (range: 60-126 minutes) and 90.2±4.6 minutes (range: 50-150 minutes) in Group 1 and 2, respectively (p=0.001). Mean estimated blood loss was 100 mL (range: 20-350 mL) and 5 mL (range: 0-10 mL) in Group 1 and 2, respectively (p<0.001). Mean length of postoperative hospitalization was 4.9±4.2 days (range: 1-13 days) and 2.9±1.8 days (range: 1-9 days) in Group 1 and 2, respectively (p=0.029). Intraoperative complication occurred in 3 patients (5.2%) (adrenal vein avulsion) and 1 patient (3.3%) (spleen laceration) in Group 1 and 2, respectively.
DISCUSSION AND CONCLUSION: LigaSure vessel sealing system had lower complication rate compared with Hem-o-lok ligation clip during laparoscopic adrenalectomy.