Efficacy and Safety of Posterior Retroperitoneoscopic Adrenalectomy: A Comparative Study

Inclusion Criteria: patients have one or more of the following; * Functioning adrenal adenoma, * Nonfunctioning adenoma \< 7 cm by pelvi-abdominal CT, * Secondary metastatic adrenal mass suitable for laparoscopic adrenalectomy, * Adrenal hyperplasia indicated for laparoscopic adrenalectomy. Exclusion Criteria: * Patients with cardiovascular disease (as angina, acute myocardial infection, congestive heart failure); history of stroke, transient myocardial attacks, coronary angioplasty or coronary artery bypass graft surgery, or any other contraindication for laparoscopy e.g. COPD, * Pregnant females, * Locally advanced malignant disease, * Evidence of regional lymph node involvement, * Vascular malignant invasion, * Malignant uncontrolled hypertension with pheochromocytoma, * Need for other simultaneous surgical intervention at the same session e.g. cholecystectomy.