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Cho, Yoo, and Kwon: A Comparison of Laparoscopic and Open Adrenalectomy in Patients with Pheochromocytoma
Original Article
Korean Journal of Urology

Korean Journal of Urology 2006; 47(6): 614-619.

Published online: 30 June 2006

DOI: https://doi.org/10.4111/kju.2006.47.6.614

A Comparison of Laparoscopic and Open Adrenalectomy in Patients with Pheochromocytoma

Deok Hyun Cho, Eun Sang Yoo, Tae Kyun Kwon

Department of Urology, College of Medicine, Kyungpook National University, Daegu, Korea.

Corresponding author (tgkwon@mail.knu.ac.kr)

Received 10 January 2006       Accepted 17 February 2006

Copyright © 2006 The Korean Urological Association

Abstract

Purpose

While the safety and efficacy of laparoscopic adrenalectomy are relatively well documented, this procedure remains challenging for pheochromocytoma. The purpose of our investigation was to assess the perioperative profiles of laparoscopic adrenalectomy (LA) with those of open adrenalectomy (OA) in patients with pheochromocytoma.

Materials and Methods

Between January 1997 and October 2005, 31 patients with pheochromocytoma underwent surgical removal, including 15 LA and 16 OA. The LA was performed via a lateral decubitus transperitoneal approach. The mean tumor size was similar in both groups (LA 6.0cm vs. OA 5.7cm). All patients underwent extensive preoperative medical preparation with alpha-blockers. The intraoperative hemodynamic instabilities and perioperative profiles were retrospectively analyzed.

Results

No conversion to open surgery was required with either procedure and no mortality was observed. Hypertensive crisis (systolic blood pressure>200mmHg) and severe tachycardia (heart rate>100/min) were more common in the OA group (LA 13.3 and 26.7% vs. OA 56.3 and 62.5%). The mean operating times for both groups were similar (LA 182.0±47.0 min vs. OA 183.1±66.5 min), but the duration of hospitalization was shorter in the LA group (LA 5.3±2.2 days vs. OA 6.8±1.0 days). The estimated blood loss was greater in the OA group (LA 103.3±44.2ml vs. OA 159.4±66.8ml). Intravenous morphine was needed in 56.3% of the OA, but in only 13.3% of the LA group. There were no significant differences in the postoperative complications between the two groups.

Conclusions

The laparoscopic resection of pheochromocytomas can be accomplished safely and effectively. A short hospital stay, with minimal perioperative morbidity and the eradication of endocrinopathy, support the minimally invasive approach for adrenalectomy in patients with pheochromocytoma.

Keywords: Pheochromocytoma, Laparoscopy, Adrenalectomy

Figures and Tables

Fig. 1
Location of trocars for a transperitoneal laparoscopic adrenalectomy.
kju-47-614-g001
Table 1
Patient characteristics
kju-47-614-i001

*: American Society of Anesthesiologists risk score grade, †: normal value: VMA 0-8mg/day, metanephrine 0-1.3mg/day, LA: laparoscopic adrenalectomy, OA: open adrenalectomy, BMI: body mass index

Table 2
Perioperative parameters
kju-47-614-i002

Normal value: VMA 0-8mg/day, metanephrine 0-1.3mg/day, LA: laparoscopic adrenalectomy, OA: open adrenalectomy

Table 3
Intraoperative cardiovascular instabilities
kju-47-614-i003

*: heart rate>100/min for 1 minutes, †: systolic blood pressure>200mmHg for 1 minutes, LA: laparoscopic adrenalectomy, OA: open adrenalectomy

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