Abstract
Objectives
We retrospectively reviewed the outcomes after laparoscopy versus an open procedure for the resection of pheochromocytoma.
Patients and methods
Forty-nine patients were enrolled into the study between June 2004 and December 2008 having been diagnosed with pheochromocytoma. The selection criteria were patients who were diagnosed with pheochromocytoma on admission based on clinical manifestations, imaging examinations and laboratory tests. Twenty-six patients underwent a retroperitoneal laparoscopic resection of their pheochromocytoma (LRP), and another 23 patients underwent an open resection of the pheochromocytoma (ORP).
Results
The ORP was similar to the LRP on the incidence of intraoperative blood pressure fluctuation. While compared to ORP, the process of LRP could effectively control the degree of fluctuations in intraoperative blood pressure(P < 0.05). Patients who received LRP had a significantly reduced volume of fluid in their drain on the first postoperative day than those who received ORP(P < 0.05), and due to the drain being removed sooner, they were consequently able to mobilize earlier(P < 0.05). The LRP cohort consisted of four patients with tumors ranging from 6 to 7 cm and three of them were successfully achieved. Intraoperatively or within 24 h postoperatively, 10 out of 23 patients who had undergone ORP received a transfusion, while none of those in the LRP cohort received a transfusion.
Conclusions
Retroperitoneal LRP allowed patients to mobilize earlier and minimized the occurrence of intraoperative blood pressure fluctuations and transfusion events. Adequate preoperative preparation and skilled laparoscopic manipulation appeared to guarantee the safety of the procedure, and large tumors did not absolutely contraindicate the use of laparoscopy.
Similar content being viewed by others
References
Rubinstein M, Gill IS, Aron M et al (2005) Prospective, randomized comparison of transperitoneal versus retroperitoneal laparoscopic adrenalectomy. J Urol 174(2):442–445
Na YQ, Wu G, Hao JR et al (1998) The use of laparoscopy in urology: report of 141 cases. Chin J Urol 36(3):143–145
Gagner M, Lacroix A, Bolte E (1992) Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma. N Engl J Med 327(14):1033
Mellon MJ, Sundaram CP (2008) Laparoscopic adrenalectomy for pheochromocytoma versus other surgical indications. JSLS 12(4):380–384
Zhang X, He H, Chen Z et al (2004) Retroperitoneal laparoscopic surgery for primary aldosteronism as compared with open adrenalectomy. Chin J Surg 42(18):1093–1095
Mikhail AA, Tolhurst SR, Orvieto MA et al (2006) Open versus laparoscopic simultaneous bilateral adrenalectomy. Urology 67(4):693–696
Fernandez CL, Tanra P, Saenza S et al (1999) Laparoscopic vs open adrenalectomy; Hemodynamic changes and catecholamine generation. World J Surg 8(8):16–21
Humphrey R, Gray D, Pautler S et al (2008) Laparoscopic compared with open adrenalectomy for resection of pheochromocytoma: a review of 47 cases. Can J Surg 51(4):276–280
Castilho LN, Simoes FA, Santos AM, Rodrigues TM et al (2009) Pheochromocytoma: a long-term follow-up of 24 patients undergoing laparoscopic adrenalectomy. Int Braz J Urol 35(1):24–31
Conflict of interest
There was no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yanbo, W., Xiaobo, D., Yuchuan, H. et al. Retroperitoneal laparoscopy rather than an open procedure for resection of pheochromocytomas could minimize intraoperative blood pressure fluctuations and transfusion events. Int Urol Nephrol 43, 353–357 (2011). https://doi.org/10.1007/s11255-010-9839-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-010-9839-z