Does hormonal function of the tumor influence the outcome of laparoscopic adrenalectomy?
BACKGROUND
Patients with hypertension, with catecholamine hypersecretion, and with cortisol excess may associate intraoperative cardiovascular instability and postoperative complications.


METHODS
To compare the outcome of laparoscopic adrenalectomy (LpA) in patients with aldosterone adenoma (11), Cushing's adenoma (six), Cushing's disease (four), pheochromocytoma (Pheo) (11), and nonfunctioning tumor (five). Intra- and postoperative parameters were studied and in patients with Pheo intraoperative catecholamine plasma levels were correlated with cardiovascular derangements.


RESULTS
Operative time, estimated blood loss, hospital stay, analgesic requirements, and time to return to normal activity were significantly higher in patients undergoing total bilateral adrenalectomy for Cushing's syndrome compared with other groups undergoing unilateral adrenalectomy, but these latter groups showed no significant differences among themselves in all parameters analyzed. One patient with nonfunctioning tumor and another with Cushing's adenoma were converted to open surgery, and two patients with Cushing's disease had urinary infection. Isolation of Pheo was associated with significant release of catecholamines but not with hemodynamic changes.


CONCLUSIONS
LpA may be the most suitable method for removing functioning adrenal tumors.
Fernández-Cruz
L
L
Department of Surgery, Hospital Clinic, University of Barcelona, C/ Villarroel, 170. 08036-Barcelona, Spain.
Sáenz
A
A
Benarroch
G
G
Sabater
L
L
Taurá
P
P
D000236:Adenoma / Q000378:metabolism / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000378:metabolism / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000378:metabolism*; D003480:Cushing Syndrome / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000378:metabolism / Q000601:surgery; D016896:Treatment Outcome
D000450:Aldosterone