Purpose: This study was designed to evaluate outcomes of transperitoneal and retroperitoneal approaches in laparoscopic adrenalectomy for resectable adrenal mass.
Methods: Laparoscopic adrenalectomy was performed on 134 patients with resectable adrenal mass between February 2004 and February 2009. We retrospectively reviewed the results of transperitoneal approach (TPA) and that of retroperitoneal approach (RPA) in terms of clinicopathologics and surgical outcomes.
Results: 80 patients (39 men and 41 women) underwent TPA, of them, 68 were located in left and 12 were located in right. 54 patients (25 men and 29 women) underwent RPA. In RPA group, 9 were located in left and 45 were located in right. There were no difference in clinicopathologics (including age, gender and BMI), in postoperative complication and in mortality. Operative time was shorter, blood loss was smaller and less pain killers was administered in RPA group (p＜0.05).
Conclusion: Our study shows that both approach (TPA and RPA) have a good peri-operative outcomes, but RPA is less painful and has a shorter operative time than TPA. It is needed to choose operative approach based on certain patient selection criteria for high patient and surgeon satisfaction.

Keywords: Adrenalectomy, Transperitoneal, Retroperitoneal, Laparoscopy