Laparoscopic transabdominal adrenalectomy was first reported by Gagner et al¹ in 1992, and it has since become the standard of care for removal of benign adrenal nodules. Compared with open adrenalectomy, the laparoscopic approach has been consistently associated with decreased morbidity (particularly pulmonary and wound complications) and faster recovery.^2,3 In the current issue of JAMA Surgery, Chen et al⁴ describe what is, to our knowledge, the largest single-institution experience of laparoscopic transabdominal adrenalectomy to date. The authors demonstrate that this is a safe technique with low morbidity (55 of 640 patients [8.4%]), mortality (2 patients [0.3%]), and conversion to hand-assisted or open surgery (9 and 15 patients, respectively [3.7% combined]). Risk factors for perioperative complications in their study included conversion to open surgery, a diagnosis of pheochromocytoma, a tumor size of 6 cm or larger, and a rating of American Society of Anesthesiologists class 3 or 4.

腹腔镜经腹肾上腺切除术是由Gagner等人¹于1992年首次报道的，此后它已成为去除良性肾上腺结节的护理标准。与开放式肾上腺切除术相比，腹腔镜手术一直与发病率降低（尤其是肺部和伤口并发症）和恢复更快相关。^{2 ，3}在当前问题JAMA外科，Chen等人⁴就我们所知，描述迄今为止迄今为止最大的单机构腹腔镜经腹肾上腺切除术经验。作者证明这是一种安全的技术，它具有低发病率（640名患者中的55名，占[8.4％]），死亡率（2名患者，[0.3％]），并且可以转换为手助或开放手术（分别为9名和15名患者[总计3.7％]）。在他们的研究中，围手术期并发症的危险因素包括转为开腹手术，诊断嗜铬细胞瘤，肿瘤大小为6 cm或更大，以及美国麻醉医师学会等级3或4。