Systemic inflammatory response syndrome in open versus laparoscopic adrenalectomy

To compare the surgical invasiveness of laparoscopic adrenalectomy with that of open surgery when the invasiveness is evaluated by the incidence of systemic inflammatory response syndrome (SIRS). Patients who underwent open adrenalectomy (35 patients) and those who underwent transperitoneal laparoscopic adrenalectomy (35 patients) were included in this study. We retrospectively investigated the incidence and duration of SIRS in the two groups. Of the 70 patients, 39 had primary aldosteronism and 31 had clinically nonfunctioning adrenal tumors. The incidence of SIRS was 51.4% (18 patients) in the open group and 31.4% (11 patients) in the laparoscopic group ( P = 0.14, Fisher's exact probability test). The mean duration of SIRS was 1.9 days in the open group and 1.2 days in the laparoscopic group ( P = 0.04, unpaired t test). Surgical site infection, which occurred in 2 patients in the open group (5.7%) and 3 patients (8.5%) in the laparoscopic group, was the only infectious complication. No patient had any severe or life-threatening complications. Laparoscopic adrenalectomy seems less invasive than open surgery, when the magnitude of the invasiveness is evaluated by the incidence of SIRS.