Comparative Analysis of Laparoscopic and Open Adrenalectomy Outcomes in Wasit Province, Iraq

Adrenalectomy Outcomes in Wasit Province, Iraq

Abstract

Objective: To compare perioperative outcomes of laparoscopic adrenalectomy (LA) and open adrenalectomy (OA) in managing adrenal tumours at Al-Karami Teaching Hospital, Wasit Province, Iraq.

Method: This retrospective study reviewed 80 patients who underwent adrenalectomy between January 2015 and December 2023. Data on demographics, tumour characteristics, operative details, and postoperative outcomes were collected. Statistical analysis included t-tests, Chi-square, and Mann–Whitney U tests, with significance set at p<0.05.

Results: Of 80 patients (mean age 37.4 years; M: F ratio 1:5.8), 70 underwent LA and 10 OA. Pheochromocytoma was the most common indication (82.5%). Compared to OA, LA had significantly lower blood loss (90 vs. 180mL, p<0.001), shorter operative time (135 vs. 158 min, p=0.008), and reduced hospital stay (1.9 vs. 3.3 days, p<0.001). No conversions from LA to OA occurred. All malignant tumours (5%) were treated with OA. Postoperative complications were minor (7.5%) and did not differ significantly between groups.

Conclusion: LA is a safe and effective alternative to OA for adrenal tumours <6cm, offering shorter operative time, less blood loss, and faster recovery, even in resource-limited settings. Adoption of laparoscopic techniques and structured surgical training could improve adrenal surgery outcomes in similar regions.