目的:本研究之目的乃是報告我們在微創腎上腺切除術的初始經驗，並比較三種不同方法，包括無氣式腹腔鏡輔助腎上腺切除術、充氣式腹腔鏡腎上腺切隱術及傳統腎上腺切除術結果之間的異同。材料及方法:從民國八十四年三月至民國八十五年十二月間，總共十三位病患於本科接受了腎上腺切除術，其中五位以傳統方法，另外八位則以無氣式腹腔鏡輔助的方法施行。而從民國八十八年七月至八十九年三月間，本科亦開始發展充氣式腹腔鏡腎上腺切除術，方式包括經腹腔或經後腹腔兩種，前者有二例，後者則有九例。所有病患的特徵及四種方式施行的結果皆有詳細紀錄，並予以統計比較。結果:所有的病患皆為單側疾病，手術時間以傳統方法最短，而以充氣式腹腔鏡腎上腺切除術這組最長，特別是經腹腔途徑的方法最久（p=0.000）。手術之血量流失以無氣式腹腔鏡輔助腎上腺切除術這組最少，以傳統方法最多。術後之止痛劑及術後醫院停滯時間皆以經後腹腔腎上腺切除術最少，而以傳統方法最多（p=0.000及p=0.004）。結論:儘管在此三種微創腎上腺切除術之選擇仍有爭論，但因其能提供較美觀的傷口及較迅速的術後恢復，故腹腔腎上腺切除術為目前眾所同意較優先的選擇。

OBJECTIVE: The aim of this study was to report the preliminary experience and to compare the results of three different modalities: gasless laparoscopic assisted adrenalectomy (GLAA), gaseous laparoscopic adrenalectomy (LA) and open adrenalectomy (OA). MATERIALS AND METHODS: From March 1995 to December 1996, total 13 consecutive patients underwent adrenalectomy at our section, 5 with traditional OA and 8 with GLAA. And from July 1999 to March 2000, we had initial experience of transperitoneal and retroperitoneal laparoscopic adrenalectomy (TLA and RLA) in total 11 patients. The characteristics of the patients and the results of the four techniques were recorded on a database. To analyze dichotomous variables, the Kruskal Wallis H test and Mann-Whitney U test were performed. RESULTS: All the patients had unilateral disease in our series. The operative time of OA is the shortest (p=0.000) and the LA group was more time-consuming, especially in the transperitoneal counterpart. Perioperative blood loss was the lowest in the GLAA group, followed by RLA, TLA, and OA group. The usage of postoperative analgesic was the least after RLA and the highest after OA (p=0.000). Postoperative hospital stay was also the shortest following RLA and TLA and the longest following OA (p=0.004). CONCLUSION: Though the best choice between one of these three minimally invasive adrenalectomies is still a debate, the better cosmetic result and quicker postoperative convaliscence suggest the laparoscopic adrenalectomy (either transperitoneal or retroperitoneal) to be the preferred modality at present.