Laparoscopic adrenalectomy for pheochromocytoma |
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Authors: | KW Kercher A Park BD Matthews G Rolband RF Sing BT Heniford |
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Institution: | (1) Department of General Surgery, Carolinas Medical Center, P.O. Box 32861 Charlotte, NC 28232, USA, US;(2) University of Kentucky, Lexington, KY, USA, US |
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Abstract: | Background: Laparoscopic adrenalectomy for Conn's syndrome, Cushing's disease, cortisol-producing adenomas, and nonfunctioning
adenomas has been well established. This study was intended to evaluate the clinical outcomes of patients undergoing laparoscopic
adrenalectomy for pheochromocytoma, and to assess the efficacy and safety of a minimally invasive approach. Methods: Data
were collected prospectively on all patients undergoing laparoscopic adrenalectomy for pheochromocytoma over a 5-year period.
Results: In this study, 39 consecutive patients underwent laparoscopic resection of a pheochromocytoma: 38 adrenal (23 left,
15 right) and 1 extraadrenal paraganglioma. There were no conversions to open surgery. The mean tumor size was 5.2 cm (range,
2-12.1 cm). Average operative time was 159 min (range, 100-265 min), and average estimated blood loss was 72 ml (range, 30-350
ml). Intraoperative hypertension (systolic blood pressure > 170 mmHg) occurred in 67% of the patients, and hypotension (systolic
blood pressure < 90 mmHg) in 39% of the patients. The mean length of stay was 2.1 days (range, 1-4 days). There were three
minor postoperative complications. During a mean follow-up period of 14 months, there were no mortalities or recurrences of
endocrinopathy. Conclusions: Laparoscopic resection of pheochromocytomas can be accomplished safely despite frequent episodes
of hemodynamic variability equal to those of historic open control subjects. A short hospital stay with expedient recovery,minimal
wound complications, and lack of endocrinopathy recurrence makes a minimally invasive approach the procedure of choice for
the management of pheochromoctyoma. |
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