Prospective randomized comparison of laparoscopic versus open adrenalectomy for sporadic pheochromocytoma
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Laparoscopic adrenalectomy for pheochromocytoma remains subject of debate, owing to the systemic consequences of pneumoperitoneum in patients with catecholamine-secreting tumors.
A prospective randomized study was conducted (2000–2006), evaluating cardiovascular instability during open (n = 9, group A) or laparoscopic (n = 13, group B) adrenalectomy for pheochromocytoma. Haemodynamic parameters were recorded by invasive monitoring.
Haemodynamic instability was observed in 3/9 (group A) and 6/13 patients (group B), with a mean of 1.8 and 2.2 hypertensive peaks per patient (p = n.s.). Blood loss (164 ± 94 cc versus 48 ± 36 cc, p < 0.05) and operative time (180 ± 40 versus 158 ± 45 min, p = n.s.) favored laparoscopic procedures. Postoperative morbidity and mortality were nil. Hospital stay was shorter in group B (p < 0.05). Long-term follow-up was always normal.
Laparoscopic approach for pheochromocytoma can be as safe as open surgery; intraoperative haemodynamic instability, although usually controlled with success, remains a source of concern.
KeywordsPheochromocytoma Adrenalectomy Laparoscopy Open surgery
The authors are very grateful to Prof. Bruno Mario Cesana of the Department of Biomedical Sciences and Biotechnology, Section of Medical Statistic, Brescia University for his valuable help in reviewing the statistical analysis of the paper.
- 8.Kebebew E, Duh QJ (1998) Benign and malignant pheochromocytoma. Diagnosis, treatment and follow-up. Surg Oncol Clin North Am 7:765–789Google Scholar
- 16.Proye C, Thevenin D, Cecat P, Petillot P, Carnaille B, Wemeau JL, Huglo D, Ernst O, Proye CA (1989). Exclusive use of calcium channels blockers in preoperative and intra-operative control of pheochromocytomas: hemodynamics and free catecholamines assays in ten consecutive patients. Surgery 106:1149–1154PubMedGoogle Scholar