Liao C.-H.Lai M.-K.Li H.-Y.Chen S.-C.SHIH-CHIEH CHUEH2021-08-022021-08-0220080302-2838https://www.scopus.com/inward/record.uri?eid=2-s2.0-47949129535&doi=10.1016%2fj.eururo.2007.12.028&partnerID=40&md5=cdad315cf24e94be019c36862b61bad6https://scholars.lib.ntu.edu.tw/handle/123456789/575550Objective: To examine the safety and efficacy of laparoscopic adrenalectomy with needlescopic instruments for most adrenal tumors less than 5 cm. Methods: Transperitoneal laparoscopic adrenalectomy with needlescopic instruments for 112 patients with presumptively benign adrenal tumors < 5 cm were enrolled from July 2000 to February 2005. Operative time, blood loss, conversion and complication rates, and postoperative data were analyzed by appropriate statistical methods. Results: All 112 operations were completed without any mortality or reoperation. Mean operative time was 151 min and mean blood loss was 30 ml. Only one patient required a blood transfusion and application of a hand-assisted device. Conversion to conventional laparoscopic instruments was necessary in another five patients (4.5%). The operative time of the latter 100 cases (147 ± 5.1 min, mean ± standard error of mean) was significantly shorter than that of the initial 12 cases (183 ± 8.8 min, p = 0.001). Larger tumors, previous abdominal surgery, and pheochromocytoma group were independent risk factors of a longer operative time. Except for one leiomyosarcoma, all other tumors were benign adrenal pathologies (57 aldosterone-producing adenomas, 23 Cushing's adenomas, 12 pheochromocytomas, and 20 incidentalomas). Conclusion: The safety and effectiveness of laparoscopic adrenalectomy employing needlescopic instruments for most adrenal tumors less than 5 cm was feasible with acceptable operative time. Pheochromocytomas can also be managed with a longer operative time. Patients with previous upper midline or ipsilateral upper quadrant open surgery might not be suitable candidates for such a technique. ? 2007 European Association of Urology.[SDGs]SDG3aldosterone; abdominal surgery; adenoma; adrenal incidentaloma; adrenal tumor; adrenalectomy; adult; aged; anamnesis; article; benign tumor; blood transfusion; data analysis; feasibility study; female; human; laparoscopic surgery; leiomyosarcoma; major clinical study; male; medical instrumentation; needelscopic instrument; operation duration; peptic ulcer bleeding; pheochromocytoma; postoperative complication; postoperative hemorrhage; priority journal; reoperation; risk factor; safety; statistical analysis; surgical instrument; surgical mortality; tumor volume; Adrenalectomy; Adult; Aged; Analysis of Variance; Female; Humans; Laparoscopy; Linear Models; Male; Middle Aged; Needles; Statistics, Nonparametric; Surgical Procedures, Minimally Invasive; Treatment Outcomejournal article10.1016/j.eururo.2007.12.028181648032-s2.0-47949129535