The purpose of this study was to determine whether surgical outcomes are different for the left- versus right-sided retroperitoneal laparoscopic adrenalectomy (RLA).

A retrospective data gathering from 269 patients who underwent RLA from Jan. 2018 to Dec. 2021 was conducted. Demographic and hospital admission data were collected including age, sex, body mass index (BMI), comorbidities (hypertension, coronary heart disease, diabetes and respiratory diseases), American Society of Anesthesiologists (ASA) score, history of abdominal surgery, operative time, estimated blood loss (EBL), tumor size, laterality, postoperative pathology, perioperative complications and postoperative length of stay from these patients with complete medical records. The surgical outcomes including operative time, EBL, postoperative length of stay and complications were analyzed and compared between left- and right-sided group.

Of the adrenalectomies performed, 150 were on the left and 119 on the right. No significant difference was found between the two groups in terms of age, sex, BMI, comorbidities, ASA score, tumor size, resection procedure and pathology type of the lesions. The median operative time of the left and right- sided RLA was 105.0 min(85.0 min, 140.0 min)and 115.0 min (95.0 min, 145.0 min) (P=0.24), respectively. The median EBL on both the left and right side was 20 mL (10 mL, 30 mL) (P=0.72). The mean postoperative length of stay between the left and right were (6.4±1.8) days and (6.7±1.5) days (P=0.16), respectively. There was no statistically significant difference in the above variables between left and right- sided RLA. The perioperative complication rate (Clavien- Dindo grade≥2) on the left and right side was 6.0% and 16.0%, respectively, which is statistically significant (P=0.01). However, there was no difference in Clavien- Dindo grade ≥ 3 complications between left- and right- sided groups (P=0.85).

No significant difference was found between the left and right laparoscopic adrenalectomy in terms of operative time, EBL, postoperative length of stay and occurrence of serious intraoperative complications. The incidence of perioperative complications above grade Ⅱ based on Clavien-Dindo classification on the right side was significantly higher than that on the left side, but there was no difference above grade Ⅲ.